MCCLELLAN HIGH SCHOOL ALUMNI ASSOCIATION, INC.
A Nonprofit Corporation
MEMBERSHIP APPLICATION
CURRENT NAME________________________________________________________________________
Last First MI Maiden
NAME USED IN HIGH SCHOOL__________________________________________________
STREET ADDRESS:______________________________________________________
CITY:_________________________________STATE:____________ZIP:___________
PHONES: HOME:_________________WORK_____________OTHER:______________EMAIL:___________________
ARE YOU A FORMER STUDENT OF MCCLELLAN?______ CLASS YEAR_______
IF YOU ARE NOT A FORMER STUDENT OF MCCLELLAN, WHAT IS YOUR INTEREST IN THIS ASSOCIATION? (CHECK ALL THAT APPLY)
________ FACULTY _________FORMER FACULTY _____________OTHER
IF YOU ARE FACULTY, PLEASE LET US KNOW WHETHER YOU ARE:
__ CURRENT FACULTY - POSITION______________________________________
__ FORMER FACULTY - YEARS AT MCCLELLAN ________________RETIRED________
ASSOCIATION CONTRACT -
__I wish to receive association notices by US Postal service.
SIGNATURE__________________________________ DATE__________________
Must be accompanied by dues payment:
| | | | 2009 - Different Ways to Join
$20.00 Friend of the School
(did not graduate from Mabelvale/McClellan)
$20.00 Individual Annual Membership
(graduated Mabelvale 1927-1960)
$35.00 Married Alumni
(both graduated Mabelvale 1928-1960)
$250.00 Mabelvale Life Time Membership for graduates
of Mabelvale, 1927-1965. Payable in installments of
$25.00 if preferred.
$30.00 Individual Annual Membership
(graduated 1961 or after)
$50.00 Married alumni-both graduated 1961 or after
$350.00 Silver Life Time membership
(Payable in installments of $35.00 a month,
if preferred. Can be upgraded to Gold at a later time.
$500.00 Gold Life Time membership
(Payable in installments of $50.00 a month,
if preferred) |
TO MAIL DUES OR MAKE CHANGES IN CONTACT INFORMATION: | |
MCCLELLAN HIGH SCHOOL ALUMNI ASSOCIATION, INC., C/O DAVID BOWDEN
P.O. BOX 193101, LITTLE ROCK, ARKANSAS 72219-3101, Sybil Bowden: 501-590-0156
ASSOCIATION OFFICE USE ONLY:
__ NEW APPLICATION __ UPDATED INFORMATION ONLY
MEMBERSHIP NUMBER ASSIGNED: ______________________
Because of administrative ease and economics, the Association prefers e-mail communications. If you provide an e-mail address, it will be considered your primary contact address unless you indicate otherwise by checking the box below. If you have no email address, communication will be by mail. Contact information can be updated by mailing or emailing changes to the Association address below or by contacting the Secretary or any board member.
OPTIONAL:
Mabelvale/McClellan Alumni:
Grand parents: _____________________________________________________________________
_____________________________________________________________________________
Parents: _____________________________________________________________________
_____________________________________________________________________________
Aunts & Uncles:_________________________________________________________________
_______________________________________________________________________________
_________________________________________________________________________________
Siblings: ________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Children: _________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Grandchildren: ______________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
