------------------------------------------------------------------------------------------------------------------------------New Rochelle High School PTSA Membership Form Please complete and return this form along with the dues (make checks out to NRHS PTSA) of $15.00 ($5.00 for students) to NRHS PTSA, 265 Clove Road, New Rochelle, NY 10801. Remember to print clearly so we can accurately add you to our email list. ___Parent/Guardian ___Staff
___Student
___Community Member
Name ______________________________________________________________ Address ____________________________________________________________ Tel: (home) ____________________ (cell) __________________________ Email __________________________________________ Student’s name _____________________________________________Grade ____ Student’s name _____________________________________________Grade ____ You can call me to be involved! _____ I am including an additional donation of $ ______________________ You can include me on current membership list (Ex: for PTSA website or newsletters): YES ____ NO ____