BADGE MEMBERSHIP REPLY FORM
www.BensalemGifted.org

Dues are $5 per year for a family or individual.
Please mail this form and your check made payable to BADGE to:
Karen Hard, 1230 Primrose Court, Bensalem, PA 19020


Name:_______________________________________________________________________

Address:_____________________________________________________________________

Phone:________________________________
Email Address (saves us postage when we can email updates:
_________________________________________________________

I am a: ___ Parent ____ Teacher ___Administrator ____School Board Member

Names, Grades, & Schools of Children:

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________



I'd like to help with (Check as many as you wish):

___ Back to School Night Info Table

___ District Sponsored Education Committees

___ Fifth Grade Transition Party

___ Social Events

___ Photocopying

___ Pride Day information table


Other: __________________________________________________________________

Are you or any of your children graduates of the Bensalem gifted program? _____

Comments:

Download this form in PDF format here