MEMBERSHIP APPLICATION
You may type the information in the boxes and then do the PRINT SCREEN:
FIRST NAME:
SURNAME (Last Name):
ADDRESS 1:
ADDRESS 2 (optional):
CITY: STATE: ZIP:
PHONE (ex.: 555-555-0000): EMAIL:
Choose the membership for which you are applying:
SINGLE MEMBERSHIP ($20 per year)
FAMILY MEMBERSHIP ($30 per year)
Do a “Print Screen” and send the copy in with your check to:
University of Alabama Alumni Association, Chattanooga Chapter
P. O. 328
Chattanooga, TN 37401