'22-'23 Butler PTA Contribution Form

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The Butler PTA offers enrichment and community building opportunities, both in school and out. We need your help to make these programs great! When you donate $5 or more to the Butler PTA, you become a member of the National PTA and receive up to two membership cards. Any donation above $5 goes directly to programs organized by the Butler PTA for our students. The Butler PTA is a 501(c)3 non-profit.

Name of parent/guardian *

Email address *

Second name, if applicable

Second email, if applicable

My donation to the Butler PTA is: *

$150

$100

$50

$25

Other Amount $________ Every dollar is helpful in supporting your child’s education at Butler!

I am not interested in donating today

How would you like to make your donation? *

https://www.paypal.com/donate/?hosted_button_id=FY2PBSRFVFNTJ

I am paying by check -- make payable to Daniel Butler PTA (Butler PTA, 90 White St, Belmont MA 02478)

I am paying by cash

I am not donating today

Double your donation through participating in company matching! Many companies – both large and small – offer matching gift programs to their employees. Simply provide the name of your company, we will contact you with instructions for requesting a matching gift. Please consider multiplying the impact of your donation. Thank you! What is the name of your company?

I would like to volunteer with the PTA! *

Yes

Not sure yet

I'm already a volunteer or a Butler PTA board member

My student(s) is/are in the following grade(s) at Butler: *

Kindergarten

Grade 1

Grade 2

Grade 3

Grade 4

Required

Home address *

Home Phone Number

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