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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
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