2015 Pride of Portage Enrollment Form All fees are due by August 7, 2015 Name___________________________________Grade Next Year (circle one) 8 9 10 11 12

____Membership ($100.00) ____Band Marching Shoes – add ($35.00)

Men’s size_____ Women’s size_____ (Please write down the size)

____Percussionist - add ($35.00) ____Color Guard Members – add ($100.00) Total for guard $200.00 unless you need shoes $235.00

Total Fees Due: ______ Shirt Size (circle one): S

M

L

XL

XXL

Checks or cash accepted. Please make checks payable to: Portage High School. Please complete the above information and attach this form, your completed HEALTH FORM AND A PHOTO COPY OF YOUR INSURANCE CARD to a music department envelope along with your payment. Forms and money can be turned into Mr. Timmerman or our Music Secretary, Mrs. Evans. All Marching Band fees for the prior year must be paid in order to be considered “in good standing.”

Payments: (To be completed by Music Department) $_____ Balance________ Date________ Cash___Check#______ Name on Check:____________ $_____ Balance________ Date________ Cash___Check#______ Name on Check:____________ $_____ Balance________ Date________ Cash___Check#______ Name on Check:____________ $_____ Balance________ Date________ Cash___Check#______ Name on Check:____________ $_____ Balance________ Date________ Cash___Check#______ Name on Check:____________ $_____ Balance________ Date________ Cash___Check#______ Name on Check:____________

Fund Raisers: $______ Date__________ $______ Date__________ $______ Date__________ Revised 5/12/15