University of Wisconsin - Whitewater, Florida Alumni Chapter
MEMBERSHIP & RENEWAL APPLICATION
Thank you for becoming a member or renewing your membership.
Paul Frey Class of '68 - Chapter President

NAME:
                                                                                 CLASS OF:                       

SPOUSE/PARTNER NAME:
                                                                                            CLASS OF:                       

FLORIDA ADDRESS:
                                                                                                                                                           

PHONE: (
              )                                                    FAX: (               )                                                      

I / we reside at this address:  YEAR ROUND or FROM
                     TO                   

"Other" Address:
                                                                                                                                                                  

PHONE: (
              )                                                    FAX: (               )                                                      

EMAIL ADDRESS:
                                                                                                                                      

                 I am a UWW-Florida Alumni Chapter member and I want to renew my membership.  Enclosed is my check, made payable to:  UWW FOUNDATION, in the minimum / annual amount of $10.00

                 I would like to be a member of the UWW-Florida Alumni Chapter.  My check, made payable to:  UWW FOUNDATION, in the minimum / annual amount of $10,00 is submitted with this application.

                 I do not want to be a member of the UWW-Florida Alumni Chapter.  However, I do wish to make a monetary contribution.  My check, made payable to:  UWW FOUNDATION in the amount of $                          is enclosed.

A paid membership (minimum / annual $10.00) with the UWW-Florida Alumni Chapter entitles its members to the following:

     *UWW Alumni cling-on sticker
     *Invitation to UWW Alumni events (beyond the St. Pete & Ft Myers events that already take place courtesy of Mark Dorn)
     *Discounts on admission to alumni events for UWW-Florida Alumni Chapter members.
     *UWW-Florida Alumni Chapter website and email updates.

Please let us know if you have any additional comments / suggestions:
                                                                                                                       
                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                       



Please mail this completed application along with your
check, payable to the "UWW FOUNDATION", to: 

Phillip Marty
9307 Rockrose Drive
Tampa FL 33647-2908

QUESTIONS ? - Contact Membership Co-Chairs: Ken Westphal or Phil Marty

THANK YOU FOR YOUR SUPPORT OF THE UWW-FL ALUMNI CHAPTER
Related Links:
Membership Application
EVENTS
PHOTOS
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