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Membership Form Cornell Alumni Association of Central New York 2007-2008

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Name 1______________________________________________

Name 2______________________________________________

ID#____________________ School/Year___________________

ID#_______________________School/Year_________________

Employer 1___________________________________________

Employer 2 __________________________________________

Employer Address______________________________________

Employer Address______________________________________

City_________________________________________________

City_________________________________________________

State____________________ZIP_________________________

State______________________ZIP_______________________

Business Phone(____)___________________________________

Business Phone(____)___________________________________

E-Mail Address________________________________________

E-Mail Address________________________________________

Home Address_________________________________________

 

City/State/ZIP__________________________________________

Home Phone(____)_____________________________________

 

Membership Dues   

q I am enclosing a check for annual membership dues for July 1, 2007 through June 30, 2008 payable to the Cornell Alumni Association of Central New York

or

q Please bill to my credit card number below.  

 

Single

Couple

 

One Year:

$20

$30

______

One Year-Recent Graduates ’02-’05:

$10

$15

______

2006 & 2007 Graduates :

Free

Free

______

Two Years:

$35

$50

______

Total:

 

 

______

q YES! I'm interested in subscribing to Cornell Alumni Magazine. Please start my subscription and have the magazine bill me -- just $29 for a one-year subscription!

□  I am interested in the Cornell Alumni Admissions Ambassador Network.

Scholarships                         

q Enclosed is my separate check, payable to Cornell University, as a gift in support of the CAACNY Ruth L. Dales '37 & Bob Bitz ‘52 Scholarship for local students. (Scholarship gifts are eligible for matching gift funds and class/Cornell Annual Fund credit only when a check separate from dues payment is submitted.) Please call the Office of Trusts, Estates, and Gift Planning if you would like more information on how you can establish a planned gift to benefit the Club’s Scholarship Fund at Cornell. 1-800-481-1865.

q Please bill to my credit card number below. 

 TOTAL SCHOLARSHIP GIFT ______ 

 

Please check (Ö): q Visa  q MasterCard  q Discover 

 

#__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Exp__ __ __ __ Signature 

 

Please return dues to: Cornell Alumni Association of Central New York; PO Box 832; Ithaca, NY 14851-0832