Membership Form

Personal Information:

First Name

Last Name
Middle Initial

Maiden
Date of Birth

Hometown & State

Street Address

Address (cont.)

City

State

Zip/Postal Code

Work Phone

Home Phone

FAX

E-mail

URL

I do not wish to have information published in the Dallas Alumni Roster
Contact me about sponsoring a Chapter Newsletter via advertisement in the Newsletter (reach over 800 households of Southernites)

Educational Information:

Department
Major/Minor
Year of Graduation

Dates Attended

Organizations while at SU

Chapter Support:

Activities
Bayou Bash
Fundraising
Sponsorships/Underwriting
Mail Preparation
Membership
Public Relations
Back-to-School Event
Student Buddy Program
Student Recruitment
Student Workshop

I am willing to publicize Dallas Chapter Foundation and/or assist in Dallas Chapter Student Recruitment & Scholarship Efforts at my...

Church
School/School Districts
Organization

Membership Dues:

Non-Life Member - $80.00 (Local Dues $30.00 + National Dues $50.00)

New Life Member - $530.00 (Local Dues $30.00 + Life Member $500.00)

        Life Member Pledge - Local Dues $30 + Life Member $500
         * Initiate with minimum payment of $70.00
           * Additional payments of at least $50.00 can be made throughout the year
           * Pledge must be completed within the 2 year period

Current Life Member - $55.00 (Local Dues $30.00 + National Maintenance $25.00)
* The $25.00 maintenance fee is used to offset Federation operating expenses

        Dallas Chapter Booster - $20.00
             * The $20.00 is used to support the Dallas Chapter. Boosters are non-voting members.
                The Dallas Chapter encourages full membership. Please consider supporting the local and national organizations. You will receive the national
                publication (Southernite) and other SUAF

Additional Dallas Chapter Donation

Payment Information:

Check
Money Order
Direct Deposit
Cash (please no cash via mail)
Online (please complete application then proceed to online membership payment site via the home page. Please note that a $3.00 service fee will apply to each transaction)

Hometown & State

Street Address
Address (cont.)
City
State
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail
URL