J.E.B. Stuart High School Parent Teacher Student Association 2016-17 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 below to download and print out a paper version of the form:

You can 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 Gender Mobile Phone Alternate Phone
  Addl Registrant First Name Last Name Gender Mobile Phone Alternate Phone
  Home Address
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/Admin/Staff Memberships
  • One Parent Membership-$15
  • Two Parent Memberships-$25
  • One Teacher/Admin/Staff Mbrshp-$5
  • Two Teacher/Admin/Staff Mbrshps-$10
$ $
2 Student 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
Drama Department
  IB Testing Proxy
  Main Office
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: or register at giantfood.com to link your Bonus card to "Stuart Code" 01932 
  Harris Teeter Vic Card No: or register at harristeeter.com to link your Vic card to "Stuart Code" 4096 
  Safeway Bonus No: or register at escrip.com to register and designate "Stuart PTSA" 6632369 
  Target REDcard: or register at target.com to link your RED card to "Stuart Code" 103651 

Student Information (currently attending Stuart)
  First Name
Last Name
Grade Gender Phone Nbr * Email Address *  Area(s) of Interest to Volunteer*




* 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.