Change of Officers Form

This form is for submitting a CHANGE in officers previously reported for this school year.

**Please note**: YOUR OFFICER INFORMATION MUST ALWAYS BE CURRENT AS REQUIRED BY THE IRS GUIDELINES.

Please fill out ONE form per changed officer. Thank you.

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*