GRASSO TECH PARENT FACULTY ORGANIZATION MEMBERSHIP FORM

Faculty/Staff Name:___________________________________________________________________

Position/Subject:____________________________________________________________________

School email address:_______________________________________________________________

School Phone Number:______________________________________________________________

Enclosed is my check for $5.00 for annual dues.   Mail to: Grasso Tech PFO, 189 Fort Hill Road, Groton, CT 06340.   If you have any questions please call John Blake at 441-0359 or Maggie Delaporta at 445-3822.