Palos Verdes Peninsula High
Parent-Teacher-Student Association 2009-2010
Parents, teachers, students, grandparents and community friends…we invite you to be a part of
our Peninsula High School PTSA! Your PTSA dues benefit every student on our campus
through gifting of educational supplies, sponsoring students to go on Capitol Convoy in
Sacramento, Reflections program, Red Ribbon Week, safety/disaster preparedness supplies and
much more! PTSA dues and donations are tax deductible.
Please complete this form…one per family. Thank you for your generosity!
1. PTSA Membership (You must be a PTSA member to purchase a PTSA student directory.)
Member Please indicate if Parent, Grade if $10 per
Student, Teacher, Other student member
If more than 4 members, please use an additional form to list names.
Total - Membership $_____
2. PTSA Student Directory (You must pay for a membership before you can purchase a directory)
I am purchasing _____ Student Directories @ $10 each.
Directory will be mailed to the address listed on the directory form. $_____
3. Disaster and Safety Preparedness
A donation of $10 per student is requested to replenish supplies for all $_____
classrooms, disaster/safety preparedness on campus and the emergency
phone contact system.
4. PTSA Donation
Please make a tax-deductible donation to the PTSA to help support the $_____
programs and events that the PTSA provides
5. Instructional Materials Donation
Please make a tax-deductible donation to the PTSA to help offset the $_____
cost of paper, ink cartridges, and additional classroom supplies.
Please make one check payable to: PVPHS PTSA Grand Total (Items 1-5)
Parent/Guardian Name______________________________________ Phone________________
Student Name(s) _____________________________________ Parent E-mail
Street Address_______________________________ City__________________ Zip Code_____
Return this form with your check on Registration Day.
After that date, mail to: PTSA, Peninsula High School, 27118 Silver Spur Road, Rolling Hills Estates, CA 90274.
Please be sure to complete the Student Directory Information Form on the following page!
PTSA 1st VP