Alpha Gamma Delta (Name, Crest, Or Squirrel)

Alpha Gamma Delta Houston Alumnae Club

Membership Form 2014 - 2015

Name: ______

First Middle Last

Maiden Name: ______Husband’s Name (if applicable): ______

_____ New Member _____ No Changes _____ See Changes Below

Address: ______

City: ______State: ______Zip: ______

Phone: Home ______Office ______

Cell ______Fax ______

Email: ______

Chapter/College: ______Year of Initiation: ______

Legacies (include daughters, stepdaughters, granddaughters and sisters):

To be a part of our sisterhood, please pay your Alpha Gam support fees of $35.00 (please note that support fees are not tax deductible).

In addition, I would like to contribute ____$15, ____$25, ____$50, ___$______Other, to the various Houston Alumnae Club programs; any amount would be greatly appreciated. Our support fees are our operating dollars while our fundraisers support the Foundation.

To pay via Paypal please use this link: https://www.paypal.com/webapps/mpp/send-money-online

And in the "To:" email address

NOTE: If you pay by Paypal, please remember to still submit a membership form

To pay by check, please make your check payable to: “Houston Alumnae Club of Alpha Gamma Delta”.

If you will be sending a check and/or membership form by mail, please contact Connie Zieba at for the mailing address.

Please Pay Your Support Fees Today. We want YOU to be a part of our Sisterhood!