Member S Last Name, First Spouse S Name

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Member’s Last Name, First Spouse’s Name

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Member Street Address City and Zip Member Phone

______Member Email- PLEASE PRINT CLEARLY Member Birthday

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1. Current Student’s Name Class of: Student’s Major Student’s Birthday

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1. Current Student’s Campus Involvement Student’s Cell Phone Student’s email

2. Current Student’s Name Class of: Student’s Major

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2. Current Student’s Campus Involvement Student’s Cell Phone Student’s email Student’s Birthday

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Children who are former students~ Name & Class Year

$ Total – Payable to Austin Texas A&M University Mothers' Club. Check # ______All major credit cards accepted (print clearly)

Card# ______Expiration ______Name on Card______

Phone #______Billing Zip ______CVV Code______

Mail Completed Application to: Daniela Knight 3200 Kittowa Cove, Austin TX 78746

Questions? Phone: 512-751-2110 or email

www.austinaggiemoms.org w Facebook – Austin Aggie Moms w Twitter @AustinAggieMoms

THANK YOU, Welcome and Gig ‘em!!