TEXAS PTA Authorization Agreement

for Automated Clearing House Transactions (ACH Credits)

If you need assistance, please email finance@txpta.org

Security of your bank account information: learn more here.

PTA Information

PTA Name
Please use full name, no abbreviated names will be accepted. *

Texas PTA ID#
Your PTA's ID # can be found in your bylaws and in your PT-Avenue account. It is the same ID# that is used when submitting a membership roster. If you are not sure of your PTA ID#, please call 1-800-TALK-PTA or email memberservices@txpta.org Thank you! * 🛈

School District (ISD)
Please use full name, no abbreviated names will be accepted. *

Bank Information

Bank Name *

Branch (if applicable)

City *

State *

Zip Code *

Transit/ABA Number (Routing #) *

Account Number *

Submitter Information

First Name *

Last Name *

PTA Role *

President

Treasurer

Other Other

Phone Number *

Email *

Automated Payment Program & JoinPTA.org Agreement

Automated Payment Program Participation *

I am not currently participating . ADD -Credit the account shown.

I am currently participating. CHANGE -Change bank information.

I hereby authorize Texas PTA to initiate credit entries and, if necessary, to initiate debit entries and adjustments for any credit entries in error, to the named PTA Checking Account indicated below and the depository named below, to credit and/or debit the same to such account. *

Yes

I understand that this authority is to remain in full force and effect until Texas PTA has received written notification, to finance@txpta.org, from an officer of the named PTA of its termination, in such time and in such manner as to afford Texas PTA and the named PTA a reasonable opportunity to act on it. *

Yes

JoinPTA.org Participation *

Yes, allow people to join my PTA on www.joinpta.org

No, do not allow people to join my PTA on www.joinpta.org

Upload a copy of a voided blank check, direct deposit form from bank or printed bank documentation of bank's routing number and your PTA bank account number.

I wish for this transaction to take place starting on this date and to recur as necessary. * +

Signature *

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