Membership Application:

PERSONAL INFORMATION

*User Name:

*Enter Your Password: *Enter Password Again:

*	Mr.Mrs.Ms.Min.Dr.

*First Name: *Last Name:

*Email Address:

Home Phone: Mobile Number:

Address: City:

State: Zip:

*Birth: Month: * Day:

EDUCATION

Udergraduate:
School: Degree: Year:

Graduate:
School: Degree: Year:

Other:
School: Degree: Year:

I wish to serve on the following committee(s).

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Annual Memberships

Please select a membership level from the list below. Thank you for your support of the OU Alumni Association of North Florida.

Student Individual Membership: $10Student Joint Membership: $15
Senior Individual Membership Age 70+: $25Senior Joint Membership: Age 70+: $35
New Grad Alumni Membership: 1 yr post graduation only: $25New Grad Alumni Joint Membership: 1 yr post graduation only: $35
Alumni/Non-Alumni Individual Membership: $40Alumni/Non-Alumni Joint Membership: $65
Lifetime Individual Membership (annual installments of $250): $1,000Lifetime Joint Membership (annual installments of $375): $1,500

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