"Official PTA Kit" Entry Form

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"Official PTA Kit" Registration Form
Form closes 11:59 p.m. EDT, Friday, September 16, 2011
Welcome, PTA leader
Please complete the following web form to register for delivery of the 2011-2012 Official PTA Kit for your PTA.

* Indicates a required field.

PTA Information IF THE PTA PRESIDENT NAME AND/OR ADDRESS IS INCORRECT, CLICK "SUBMIT" TO GO TO NEXT PAGE TO ENTER CORRECTED INFORMATION. Instructions: Enter PTA ID number then click verify button. You'll see the PTA address displayed. You'll be given the chance to update this shipping address on next page. Complete all required fields.

* Unit ID		Unit Name
Name
Address		City
State		ZIP

Authorized Representative Information
* First name		* Last name
* PTA position		E-Mail address

By submitting the Official National PTA Back to school Kit registration form, I attest that the information provided is accurate and correct.

Terms of Agreement: I am a current officer of the PTA for which I am requesting the Official National PTA Back to School Kit, or have been elected as a 2011-2012 officer. I understand that the Official National PTA Back to School Kit is for the use of my PTA for the 2011-2012 year and agree to ensure that it gets to the 2011-2012 PTA board of directors.

If you have any questions, please contact the PTA Information Center at (800) 307-4PTA (4782) or e-mail info@pta.org

		* I Agree

Form closes 11:59 p.m. EDT, Friday, September 16, 2011