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Name:

Nickname:

Address:

Phone number:

E-mail:

Year of Initiation:

Candidate Class:

Offices held, if any:

President
Vice-President
Vice-President of Membership
Vice-President of Special Projects
Treasurer
Secretary
Historian
Alumni Secretary
Parlementarian

 

Would you like information on life membership?

Yes
No

Would you like information on how to join the National Alumni Association?

Yes
No

Would you like information on how to join the Western District Joint Alumni Association?

Yes
No

 

Any comments?