ALECPTA MEMBERSHIP FORM

 

__________ New Member                            __________ Rejoining Member                   Today’s Date _____________

 

 

NAME: _________________________________________________ SPOUSE: _________________

ADDRESS: ________________________________________________________________________

CITY: _____________________________ STATE: _____________ ZIP CODE: ________________

PHONE: ___________________________

EMAIL (Please print clearly): _________________________________________________

 

________ Check here if you wish to receive the newsletter via mail instead of email.

Newsletters and announcements will be posted on our website and delivered by email.  If you are not able to receive your newsletter via email, you may receive them by mail.  Please note that if you chose to receive information by mail, you will not receive any special announcements that are sent by email.

 

Child Information:

                  NAME                              DOB                                 NAME                              DOB

1.______________________     ____________        4.______________________     ____________

2. _____________________      ____________        5. ______________________    ____________

3. _____________________      ____________        6. ______________________    ____________

 

School(s) they attend: ­­­­­­­­­­______________________________________________________________

 

About you:

                  EXPECTING? __________     DUE DATE: ___________

 

Current, Previous Job & Talents ­­­­­____________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

 

Hobbies __________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

 

Please sign here indicating your permission to post photos on ALECPTA’s website of you and your family that may be taken at ALECPTA events.  Children’s names & any other personal information will never be posted.                                                                           __________________________________ (Signature)

 

I understand that my children must be accompanied by a parent or responsible adult at all children=s activities and that the parent or adult is responsible for the children=s behavior and safety.  In case of an accident, neither the Avon Lake Early Childhood PTA nor its members shall be responsible.

                                                                           __________________________________ (Signature)

 

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To help give back to the organization, every ALECPTA member is required to serve on a committee AND provide a food dish one month.

Please check the committee(s) that interest you over the page.

Thank you in advance for your help!

 

COMMITTEE JOB DESCRIPTIONS:

 

______ Children’s Parties:      Help organize, set-up, or clean-up the different children=s parties.

______ Kid’s Closet:                Help organize, set-up or clean-up at this fundraiser.

______ Sunshine Committee:  Help prepare meals for other members who recently gave birth or who                                                     are in need.

Name: ____________________________________________   Phone: _________________________

 

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HOSPITALITY: We ask that all members sign up for one month in which you are able to bring an appetizer or dessert to a meeting.  Hospitality will contact you with further details prior to that meeting.

 

___ Oct.          ___ Nov.          ___ Dec.          ___ Jan.          ___ Feb.          ___ Mar.          ___ Apr.

 

Please specify:       _____ Appetizer              or                                 _____ Dessert

 

**Board members need not complete this section, as they are committed to providing an appetizer or dessert for the first meeting in September.

 

Name: ____________________________________________   Phone: _________________________

 

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If you or your spouse own or operate a small business that you would like members of ALECPTA to know about, please list it below.  The information will be included in our membership directory.                                                                       

Business Name ___________________________________ Type of Business ____________________

Phone _________________ Email and/or website __________________________________________

 

Please sign here indicating your permission to include any of the above information in our membership roster.  This is only released to our members.

                                                                           __________________________________ (Signature)

 

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(Please retain this bottom portion for your records)

 

General Meetings (September through May) will be held on the 2nd Monday of each month at 7pm, unless otherwise specified.  Sign-ups for Children=s Outings begin at 6:30pm, unless otherwise specified.  We meet in the Gallery Room at the Avon Lake Public Library.

 

Annual dues are $20.00. You will receive a monthly newsletter (as well as updates via email) & will be entitled to participate in all activities.  Please make checks payable to ALECPTA. 

Submit this completed form & your dues to the Membership Committee at any General Meeting, or send, in a sealed envelope, to the following address:

 

Zoe Cummings,  671 Parkside Drive,  Avon Lake,  OH  44012

 

Any questions or concerns may be directed to the Membership Committee:

Zoe Cummings 933-0671 * Laurie Borland 930-0652

Kelly Bova 930-0674 * Aerin Lockner 440-625-1100 * Larissa Ryan 930-8796

 

Welcome to the group!!