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Please complete this form to start or renew your membership to the LECPTA. Please note that registration is not complete until payment is made. After you click Accept, you have a chance to either pay with a credit card or send in a check.

Last Name	First Name	Membership Type

Street Address	City	State	Zip

Phone Number	Mobile Number	Spouse Name

e-mail *

First Child Name/DOB
Second Child Name/DOB
Third Child Name/DOB
Fourth Child Name/DOB
Fifth Child Name/DOB
Playgroup	Age	Special Interest Groups

Home Tour Volunteer Request
How did you hear about us?
Payment Method

The Lakewood Home Festival is LECPTA’s only fundraiser, which benefits Lakewood Elementary, J.L. Long Middle School , and Woodrow Wilson High School . It is an important part of membership to volunteer for at least one shift during home festival weekend. Please note this year’s festival dates of November 11, 12, and 13, 2011 on your calendar. You can indicate above which events interest you. Watch for volunteer schedules in the fall to sign up for your shift!

Please click Accept to register with the LECPTA and to get information on payment options.

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Lakewood Early Childhood PTA