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everychild. onevoice.

Membership fee is $5.00 - no obligation required

Goshen Lane Student Directory is FREE with a paid membership.

This money helps fund a wide range of PTA sponsored student activities & resources.

Please Print Clearly

Parent(s) or Guardian Name:

Address:

Please check the box to tell us the best number to use to contact you

Home Phone:

Work Phone:

Cell Phone:

Best time to reach you is:

Through email is the best way to stay informed on school activities!

Email:

I do not have email - please contact me by phone.

Child's Name

Teacher this Year

Thank you for supporting your PTA.

Together we are one powerful voice for our children.

For our records only

collected by

Paid by check #________ or cash on ____/____/____