Membership
On-Line Registration
Fathers Name
Mothers Name
Family Name
*
Street Address
*
Address Line 2
City
*
State
*
AZ
AL
AK
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
-Terr.-
AS
FM
GU
MI
PR
VI
Postal Code
*
E-mail Address:
*
Daytime Phone
Evening Phone
Cell Phone
Student Full Name
*
Graduation Year
*
Senior (2010)
Junior (2011)
Sophmore (2012)
Freshman (2013)
Student 2 Full Name
Student 2 Graduation Year
Senior (2010)
Junior (2011)
Sophmore (2012)
Freshman (2013)
Membership Type
*
Family Membership (2 Cards) $30.00
Single Membership (1 Card) $20.00
Activity Calendar $5.00
Please add my information to the SMHS Family Directory
*
Yes
No
SMHS Family Directory $5.00
I am interested in helping with PTC programs and/or activities.
*
Yes
No
Volunteer Opportunities
Project Graduation
Membership
Homecoming
Lunch Sales
Scholarships Fund
Other
Time Available
Daytime
Evening
Either
Comments or Questions
*
Required
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