MEMBERSHIP APPLICATION

Please submit the following form to become a member of the TSU National Alumni Association or to renew your membership. However, if you reside in an area where there is a local alumni chapter, you should submit your local dues through that chapter along with your national dues to be considered a fully financial member of the TSU National Alumni Association. You may visit the following page to view a list of all local alumni chapters: http://www.tnstate.edu/alumni/chap2.htm

SALUTATION
 Mr.   Mrs.  Ms.  Dr.
*FIRST NAME
MAIDEN NAME
*LAST NAME
*ADDRESS 1
ADDRESS 2
*CITY
*STATE
*ZIP CODE
PREFERRED PHONE
PHONE TYPE
 Home  Work  Cell  Pager
GRADUATION YEAR
   OR
YEARS OF ATTENDANCE
 e.g. 1980 - 1982 (enter only if not a graduate)
DEGREE & MAJOR
  e.g. B.S. Sociology
E-MAIL ADDRESS
*HOMETOWN CITY
*HOMETOWN STATE
OCCUPATION
EMPLOYER
MARITAL STATUS
NUMBER OF CHILDREN
LOCAL CHAPTER
TYPE OF MEMBERSHIP

- $25 Annually
      (Open to anyone who attended TSU)
- $25 Annually
- $25 Annually
      (Did not attend TSU at all)
Millennium Membership - $250**
      (10-Year membership payable in one lump sum or w/in 12-month period)
National Life Membership - $500**
      (Payable in one lump sum or w/in 12-month period)

** Will receive the Millennium Lapel Pin upon final payment!!
Note: The above fees do not include local or regional dues if you plan to be affiliated with a local chapter.
I'd also like to make a donation to the TSUNAA of $

AMOUNT TO BE MAILED

$

Make checks payable and mail to:
TSU National Alumni Association
3500 John A. Merritt Blvd.
Nashville, TN 37209-1561

Call Darlene G. Harris for more information: (615) 963-5885
COMMENTS/QUESTIONS



 

 

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