PSS Membership Form

Print out this membership form to fill it out. We need this information to update our database with the most accurate information.
(Make check payable to Parents for Public Schools of Syracuse and mail to:
Parents for Public Schools of Syracuse, Inc., P.O. Box 6043 Syracuse, NY  13217-6043
(Membership and contributions are tax deductible.)

Name________________________________________________________________________

Address________________________________________________ Zip Code______________

Home Tel ________________________________E-Mail_______________________________

Work Tel _______________________________ Occupation (optional)_____________________
Preferred method of contact:  Postal mail_____ email_____

If two adults in the same household are joining, please fill out the following:

2nd Adult’s Name_______________________________ E-mail___________________________

Work Tel__________________________________ Occupation (optional)___________________
Preferred method of contact:  Postal mail_____ email_____

Child's year of birth                                             Current school name
1._______________________________        __________________________________________
2._______________________________        __________________________________________
3._______________________________        __________________________________________
I do not have a child in Syracuse schools at present:_________________

I would like my membership to be at this level:**
____$5 Membership                ____$20 Contributing Membership     ___$100 Sustaining Membership
____$10 Family Membership   ____$50 Supporting Membership       ___Other Amount $________
** No one will be denied membership due to lack of funds.

I would like to be involved on the following PPS committee/s:
____Membership/Outreach                 ____Fundraising             ____Celebration of Excellence
____Political Action                            ____Newsletter  

PPS School Connection: We are looking for PPS members willing to distribute information and make announcements about PPS at PTO meetings in their schools and who would also call, E-mail or bring to PPS meetings parent feedback, questions and concerns from their schools.
____Please send me more information.
If you would like to be the PPS connection to your child's school Contact Us.