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Springfield PTA Remittance Form

This is a remittance form for the Springfield PTA Council.

Name of PTA Unit

Unit Number

Address of Unit

Submitted by

Phone (555) 555-5555

Position

Email

Date Submitted

Check #

Comment

Per Capita Dues (due monthly)

Members Count

Fee per Member $

Member Dues $

One time annual Council Dues (due 11/1)

Include Dues

Annual Dues $

Annual Council Dues $

Donation (optional)

$

Total Check Amount $

TIFF

3ba937dd2c0721e9e1b9eb3846ceed48f45de3bb

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Springfield PTA Remittance Form

Unit Details

Submission Details

Amounts