Name and Address:

Telephone: Fax: 

E-Mail: 

Cadet:Cadet's class: 19831984 1985 19861987 1988 19891990 1991 19921993 1994 19951996 1997 19981999 2000 2001 2002 2003 2004 Other...If "Other," please specify: 

Cadet's Birthday (for cards):

Cadet's P.O. Box: 

Academy Activities (sports, clubs, etc.): 

May we publish your address and phone number in the Chapter directory?Yes No

$20 Chapter membership (per year for each family unit -- covers July 1, 1999 to June 30, 2000)

Would you like to make an additional donation to support Cadet Enrichment activities? (e.g., goodie bags, pizzas, subs, & sodas for Cadet groups coming into our area)

Yes No donation at this timeIf "Yes," please indicate amount of donation: 

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I want to help with the following committee(s):
Social (Cadet Events)
Social (Dinner/Parent Events)
Ways & Means
Phone Chain
All Academy Holiday Ball
Other (specify)

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Please print this form and mail it with your check (payable to: "Chesapeake & Potomac Chapter, CGAPA") to:

(Contact the Chapter Treasurer, Roni Briese, for mailing address)

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This page last updated on August 2, 1999.