BHS PTSA MEMBERSHIP

Circle One         Category

Name_____________________________________________                                     P S F L O     P=Parent

                                                                                                                                                S=Student

Name                                                                                                                    P S F L O     F=Faculty

                                                                                                                                                L=Texas Life

Name                                                                                                                    P S F L O     O=Other

Name                                                                                                                    P S F L O

Address:                                                                       City                  Zip                    Phone                          

Student’s Name@BHS                                                                                                   Grade                          

Student’s Name@BHS                                                                                                   Grade                          

Student’s Name@BHS                                                                                                   Grade                          

Membership dues are: $5.00 each                                   Make checks payable to:  BHS PTSA              

TX Life Members: $3.75 each                                          Please indicate amount enclosed for dues: $                   

Thanks for your support!      Please mark envelope to: BHS PTSA Membership