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Oceanside SEPTA (Special Ed PTA) Membership Form
Name: ______________________________________________________________
Address: ____________________________________________________________
___________________________________________________________________
Home School: ___________________________________
Phone: ___________________________________
E-mail: ______________________________________________________________
Student's Name: ______________________________________________________
Student's School: _____________________________________________________
In order to develop a parent network and informative presentations and
workshops please indicate any behavioral, medical, or school related
issues that affect your child & your family (i.e. specific diagnosis, learning
disabilities, homework, stress management, working with teachers):
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Family membership $10.00
PLEASE MAKE CHECKS PAYABLE TO: OCEANSIDE SEPTA
and bring to a Septa meeting or send to:
SEPTA, 145 Merle Ave, Oceanside, NY 11572