Membership Form Last Name: First Name: Department: Title: Home Address: address Home Phone: e.g., (770) 123-4567 Business Phone: e.g., (678) 466-1234 E-Mail:
Membership Form
address
Membership Dues
Annual Dues: dues $ 7.00 Member (Funds go into the Women's Forum Operating Expenses budget to support programming, gifts, stationery, postage, and all other necessary costs associated with operation.) $27.00 Contributing Member ($20.00 is a tax-deductible contribution to the University Foundation in support of the Women's Forum) $77.00 Sustaining Member ($70.00 is a tax-deductible contribution to the University Foundation in support of the Women's Forum)
Complete this form online and send your membership dues to our staff or faculty co-chair: Vickie Smith, Membership Co-Chair, Staff Grants and Contracts, Student Center, STC 270 Dr. Annita Hunt, Membership Co-Chair, Faculty Math Department, University Center, UC 431 Make checks payable to "Clayton State University Foundation -- Women's Forum" Personal checks and Visa or MasterCard are accepted. Please call (678) 466-5082 or (678) 466-4432 if you have any questions.
Complete this form online and send your membership dues to our staff or faculty co-chair:
Vickie Smith, Membership Co-Chair, Staff Grants and Contracts, Student Center, STC 270 Dr. Annita Hunt, Membership Co-Chair, Faculty Math Department, University Center, UC 431 Make checks payable to "Clayton State University Foundation -- Women's Forum" Personal checks and Visa or MasterCard are accepted. Please call (678) 466-5082 or (678) 466-4432 if you have any questions.
