Post Office Box 72212 - Durham, North Carolina
27722
E-mail:
Durham_Eagles@Yahoo.Com
Application of
Membership
Date:_____________________________________
MR.() MS.() MRS.() DR.() REV.()
NAME:_____________________________________
____
________
ADDRESS: _________________________________________________
CITY:_____________________________________
STATE:_____________________________
ZIP Code:_____________________________
Home Telephone:___________________________Work:_________________________
E-mail Address:_____________________________________
Personal Web Page: http://__________________________________________
Graduation Date(s):________________________Degree(s):_____________
Are You A: New Member () - Renewing Member () - Life Member () - Student Member () - Other Type Member ()
| Student Recruitment () | Fundraising () | Club Membership () | Club Social Activities () |
| Finance () | News Letter () | Scholarships () | Band Concerts () |
| Dinner Dance () | Public Relations () | Alumni Band () | Band Logistics () |
| Other Interest () |
| Basic Membership Dues: | $25.00 | Per Year | () |
| Patron Member: | $100.00 | Per Year | () |
| Band_Wagon Member: | $250.00 | Per Year | () |
| Life Patron Membership: | $500.00 | Life Time | () |
| Student Member: | $10.00 | Per Year | () |
*SPECIAL CONTRIBUTION*
I Would Like To Make A Special Scholarship Contribution In The Amount Of: $______________, IN Support of the NCCU Sound Machine Bands.
I would like to Purchase or Donate a Band Uniform(s) or the following type(s) of Musical Instrument(s) for the NCCU Bands.
_________________________________________________
Please Make Your CHECK OR MONEY ORDER Payable
To:
(SM Booster Club) Durham Chapter - NCCU Alumni
Association.
Please Click Here
To Pay Your SMBC Membership Dues or Band Contribution OnLine
| News Letter () | Internet () |
| News Media () | Other Alumni () By Whom: ________________________(Please Specify): |
For Additional Information, Please E-mail us at: Durham_Eagles@Yahoo.Com
NCCU Sound Machine Booster Club Web Site
Revised: 03-29-2001