logo
ALUMNI ASSOCIATION

WSU Alumni Association
Membership Application
University Faculty and Staff Special Rate


�

Membership Options for Faculty and Staff:

$25 Single Annual Membership $35 Double Annual Membership �

� � � � � � � � � � � � � � � � � � � � (Membership is open to all alumni and friends of WSU.)
�

 

Personal Information:

First Name:
Last Name:
Graduation Year (if applicable):
My WSU ID:
Nickname:
Spouse Name:
Maiden Name:
Spouse Graduation Year (if applicable):
Spouse's My WSU ID (if applicable):
Address:
City:
State:
Zip:
Country:
Home Phone:
Mobile Phone:
FAX:
E-mail:

 

Job Information:

Name of Business:
Your Title:
Business Address:
City:
State:
Zip:
Country:
Work Phone:
FAX:
E-mail:


Payment Options:

Submit this form and mail the printout (next page) with your check as payment.
Enter my credit card information on secure pages.
Call in my credit card information.

� � �

Your new membership card will be mailed to you after we receive your payment. �Thank you!

WSU Alumni Association
1845 Fairmount
Wichita, KS 67260-0054

If you have questions, please call Stacy Shanahan at:
Phone: (316) 978-3826
Toll Free: 888-316-2586
�

�