2008 - 2009 Membership Form |
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| Name: ________________________ | Graduation Year: _________ | ||
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| Name: ________________________ | Graduation Year: _________ | ||
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| Address:_____________________ | Phone (H): ______________ | ||
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| ____________________________ | Phone (W): ______________ | ||
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| E-Mail Address: ____________________________________________ | |||
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| Membership year
for the Dayton Chapter - Penn State Alumni Association is July 1, 2008, to
June 30, 2009. Dues are $20/person or $25/family.
A portion of your dues will go to the local chapter scholarship fund. IN ADDITION TO my dues payment, I wish to make a donation to the Penn State Chapter Scholarship Fund. |
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( ) $25 |
( ) $15 |
( ) Other |
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| TOTAL DUES AND DONATION $____________ | |||
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| Make checks payable to DAYTON CHAPTER OF THE PENN STATE ALUMNI ASSOCIATION (DCPSAA) and mail to Edie Kreider, 2858 College Hill Ct., Beavercreek, OH 45431-8543. | |||