Change of Officer Information

PLEASE COMPLETE the information below. YOUR OFFICER INFORMATION MUST ALWAYS BE CURRENT AS REQUIRED BY THE IRS GUIDELINES.

Please fill out one form for each officer change.

• AFTER COMPLETION OF YOUR FORM: Check your email for the email confirmation of the form submission.

Membership Year*
Select the year you are serving as officer of PTA/PTSA
Name of PTA*

As listed in your bylaws
National PTA Local Unit Number*
County*

(i.e. Orange, Pinellas, Seminole, etc.)
Principal's First Name*
Principal's Last Name*
Principal's Email*
ALL OFFICER INFORMATION MUST BE COMPLETE TO INCLUDE THE OFFICER'S NAME, HOME ADDRESS, PHONE NUMBER AND EMAIL ADDRESS
President's First Name*
President's Last Name*
Home Mailing Address
City President
Zip Code President
President Email*
President Phone*
TITLE OF OFFICER/COMMITTEE CHAIR BEING CHANGED*
DATE OF MEETING CHANGE VOTED ON*
LAST NAME OF NEW OFFICER/COMMITTEE CHAIR*
FIRST NAME OF NEW OFFICER/COMMITTEE CHAIR*
Home/Street Mailing Address of New Officer/Committee Chair*
City/Zip Code of New Officer/Committee Chair*
PHONE NUMBER New Officer/Committee Chair*
EMAIL ADDRESS New Officer/Committee Chair*
FULL NAME of PERSON BEING REPLACED*
EMAIL ADDRESS of PERSON BEING REPLACED*
Name of Person Completing Form*
Your Email*