UVI Alumni Association - Registration Form
Alumni Update Form Please mail to the address below or print and fax to (340)693-1045. (Type or print) Legal Name: ___________________________________________________________________________________ Last Name First Name Middle Initial Maiden or other name(s): _____________________ Social Security Number ___ - __ - ____ Mailing Address: ___________________________________________________________________________________ Address City State Zip Code Phone Number Permanent Address: ___________________________________________________________________________________ Address City State Zip Code Email Address ________________________________________________________ Class Year/ Period Attended UVI: _________________________________________ Home Phone: (_____) ______________ Business Phone: (_____) ___________________ Any immediate family members presently attending UVI? …
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Alumni Update Form Please mail to the address below or print and fax to (340)693-1045. (Type or print) Legal Name: ___________________________________________________________________________________ Last Name First Name Middle Initial Maiden or other name(s): _____________________ Social Security Number ___ - __ - ____ Mailing Address: ___________________________________________________________________________________ Address City State Zip Code Phone Number Permanent Address: ___________________________________________________________________________________ Address City State Zip Code Email Address ________________________________________________________ Class Year/ Period Attended UVI: _________________________________________ Home Phone: (_____) ______________ Business Phone: (_____) ___________________ Any immediate family members presently attending UVI? YES___ NO___ If yes, Name/Relationship: ________________________________________________________ I, ______________________________ hereby register as a member of the UVI Alumni Association ______________________________ Chapter and pay the: _______ Annual membership dues of $25 to $35 (varies among Chapters) or _______ Lifetime membership dues of $250 by December 31, 2004, and $500 thereafter Signature ______________________________ Date _________________________________ UVI Alumni Association, c/o Alumni Affairs, #2 John Brewer's Bay, St. Thomas, VI 00802-9990 University of the Virgin Islands