New Grad Special
Alumni Membership Application

Please choose one desired membership category:

$20 Single Annual 
(normal rate: $40)

 $100 Single 3-Year
 		 $550 Single Life
 
$25 Couple Annual
 (normal rate: $50)		 $125 Couple 3-Year
 		 $700 Couple Life
 

Or Five-Year Installment Plan for Life Membership:

$125 Single $160 Couple  

 
Check this box if you are replying to an invoice you received for membership renewal.

Personal Information:

First Name:
Last Name:
Nickname:
My WSU ID:
Spouse Name:
My WSU ID: (if applicable)
Address:
City:
State:
Zip:
Country:
Home Phone:
Cell Phone Number:
E-mail:

Job Information:

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


In Addition:

MEMBERSHIP RENEWAL:

Please consider these two optional renewal services:

Sign me up for AUTOMATIC BILLING. My credit card will be charged the appropriate membership rate at renewal time, automatically renewing my association membership. (If you would like to sign up for this service, please consider paying today with your credit card. We will keep the information on file for Automatic Billing. If you choose this service and pay by check today, you will be contacted for your credit card information.)

Sign me up for ONLINE RENEWAL. When my membership expires, I will be sent a renewal notice via e-mail instead of a paper notice. (If you sign up for this service, please keep us apprised of your current e-mail address.)

WSU SOCIETY MEMBERSHIP:

If you are affiliated with one of the following groups, your membership with the Alumni Association can include membership in these groups:

Please indicate your choice:
Nursing Alumni Society
Bands Alumni Club
Barton School of Business Society
Elliott School of Communications Society
Social Work Alumni Society

PLEASE HELP US:

How did you find out about the benefits of joining the Wichita State University Alumni Association (check all that apply):

This Website
Membership Brochure
The Shocker Magazine
Alumni Association Employee
Another Member
New Grad Postcard
Other

Payment Options:

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


Your membership package will be mailed to you after we receive your payment. Thank you!

WSU Alumni Association
1845 Fairmount
Wichita, KS 67260-0054

Phone: (316) 978-3826
Toll Free: 888-316-2586
Fax: (316) 978-3088
 

 

This site is maintained by ALUMNI ASSOCIATION. This page last modified on Thursday, June 30, 2011 8:29:04 AM Central US Time. If you find errors please bring them to the attention of Erin Stieben (erin.stieben@wichita.edu).