J.E.B. Stuart High School Parent Teacher Student Association 2012-13 Membership Application

To make registration in the Stuart PTSA as easy as possible, we are accepting online payments for annual membership and donations. You can pay online below, securely and conveniently, using your credit, debit card, check or with a PayPal account. You do not have to have a Paypal account in order to pay using PayPal.

Complete the form below, including your membership contribution, and submit using the button at the bottom of the form. Alternatively, you can click here to print out a paper version of the form and then mail the completed membership form to: JEB Stuart High School - PTSA 3301 Peace Valley Lane Falls Church, VA 22044.

Note: Once you have completed your online registration form, you will be redirected to the PayPal website to pay for your membership items. The PayPal website is not under the control of the Stuart PTSA or Fairfax County Public Schools.



Parent/Teacher/Student Address Information
 
Registrant First Name Last Name Mobile Phone Alternate Phone
 
  Addl Registrant First Name Last Name Mobile Phone Alternate Phone
 
  Home Address
    
     
  City
 State
 Zip Code
 
  Primary Contact Email
 Alternate Email
  
   
NOTE: Email addresses are used for PTSA correspondence only and not sold or traded.
 

Membership Types
Please select your membership types. Payments can easily be made via our Secure payment processor PayPal.

# Item Description Selected Items Item Cost Line Cost
1 Parent, Teacher or Student Membership
  • Parent Membership-$12
  • Teacher Membership-$5
  • Student Membership-$5
 $ $
2 Additional Memberships $ $
3 Hospitality (optional but requested) $ $
4 Student Enrichment (optional but requested) $ $
5 Teacher Grant (optional but requested) $ $
6 Additional Donation
  • The General's Club-$250
  • Blue & Red-$125
  • Stuart Patron-$75
  • Booster Friend-$35
  • Enter your own Donation
 $ $
Total Items Selected: Total Cost: $
 

Areas You Can Help With at Stuart
Check any of the following areas in which you are willing to volunteer.
  Athletic Boosters
Clinic
Drama Department
  IB Testing Proxy
Hospitality
Library
  Main Office
Membership
Parent, Teacher, Student Association (PTSA)
  Music Dept - Band
Music Dept - Chorus
Music Dept - Orchestra
 
Please describe other areas where you can contribute, for example: guest speaker, science fair judge, area of expertise, chaperone etc.:
 

Turn Your Groceries Into PTSA Funds
Let the PTSA sign you up so your purchases make a difference for our school, click here to read more.
  Giant Bonus Card No:
  Harris Teeter Vic Card No:
  Safeway Bonus No:
 

2012/2013 Student Information
  First Name
 Last Name
 Grade Phone Number * Email Address * Area(s) of Interest *
 





 





 





 





* Student Volunteers! We welcome and encourage student participation. If you are interested in helping out, please provide your phone number, email address and areas of interest to volunteer. Volunteer hours will be counted toward your community and service hours.
 

When you have completed the registration information above, click the submit button. You will then be redirected to the Stuart PTSA PayPal website for an easy and secure payment of your registration fees and generous donations.

We look forward to meeting you and helping our school to be even better!

Questions, comments, suggestions? Please email membership@stuartptsa.org or call Michelle at 703-532-6572