Honorary State Life

Honorary State Life
An Honorary State Life Membership is given for meritorious and outstanding service on behalf of children and youth. For $75 the recipient will receive a Certificate, Pin and Wallet ID Card. An appropriate acknowledgement will be mailed to the honoree or to the family of the deceased informing them of your gift to the Florida PTA. The amount is not mentioned. Unless otherwise specified, the net proceeds from your contribution will go into the Scholarship Fund, after covering expenses.
For $75, the Recipient will receive a Certificate, Pin and Wallet ID Card. For a Leatherette Frame (add $7.00)
Make sure the information you provide is complete and accurate for the printing of the certificate.
MemoryHonor Of(*)
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First Name of Honoree(*)
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Last Name of Honoree(*)
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Email of Honoree(*)
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Email of Recipient (enter none if in memory of deceased)

Recipient Street Address(*)
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City of Recipient(*)
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State of Recipient (*)
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Zip Code of Recipient(*)
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County of Recipient(*)
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Honored By(*)
Please type your full name.

(Example: A PTA or a person honoring someone else)

Presentation Date(*)

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Certificate should be mailed to:
First Name of Applicant(*)
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Last Name of Applicant(*)
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Email of Applicant(*)
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Street Address of Applicant (*)
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City of Applicant(*)
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State of Applicant(*)
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Zip Code of Applicant(*)
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Applicant Phone Number(*)
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You must mail your payment immediately upon completion of this application. Enter the date you are processing this application and mailing payment. MAIL TO: Florida PTA, 1747 Orlando Central Parkway, Orlando, FL 32809
MAIL DATE(*)

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