2006-2007 Membership Information Form
Name:
First
Middle:
Maiden
Last
Street Address:
City:
State:
ZIP Code:
Email Address:
Birth Date:
Collegiate Chapter:
Initiation Date:
Occupation:
Interests:
Spouse:
Children (and ages):
Phone:
Home:
Cel:
Work:
I am interested in volunteering for the following committee(s): (Send me more information.)
I prefer to be contacted the following way for event information:
The following event locations are most convenient for me:
I am interested in the following types of chapter events:
Heart-to-Heart
Email
Alpharetta
Friends & Family Gatherings/Parties
Founder's Day Planning
USPS Mail
Cumming
Educational Programs
Membership
Automated Phone Call
Roswell
Cultural/Recreational Activities
Philanthropy
Personal Phone Call
Other (please specify)
Charity Work (please list eg women, children, etc)
Photography/Scrapbook
Other (Please specify. We welcome your suggestion!)
Co/Hosting Events
Panhellenic
Levels of Annual Giving
Please mail check(s) to:
Greater North Fulton Phi Mu Alumnae Chapter
c/o Scarlet Monroe Pettit, Treasurer
2180 Lexington Lane
Cumming, GA 30040
If paying by check, please mail to the address below after sending this form. Otherwise, PayPal is available for your convenience by using the Pay Dues by PayPal form below.
Please see the
current newsletter
for Level Descriptions.
Be sure to visit the Dues Submission Page if you are paying dues by PayPal.
Standard: $35
2006 New Grad: $30
Carnation Level: $50
50-year+ Member: Free
Additional Charitable Contributions (Optional)
Checks only, please. Make check directly payable to the charity of your choice
Childrens' Miracle Network
$
Phi Mu Foundation
Heart-and-Hand Fund
$
Project HOPE
$
Total of all checks being submitted by mail or PayPal:
$
Is there anything else you would like to tell us?
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