P.O. Box 30784, Memphis, TN 38130
Membership Application
(Please Print)
Check One:
P.O. Box 30784, Memphis, TN 38130
ð Annual Membership
ð Associate Membership
ð Life Membership
ð Exempt Membership
ð Honorary Membership
P.O. Box 30784, Memphis, TN 38130
Last Name First Name: MI/Maiden: Date of Birth (mm/dd):Street Address: City: State: Zip Code:
Phone: Home : Mobile: Other:
Email Address(es):
Year(s) Graduated: or Year(s) Attended: Major:
Current Employer and Job Title:
Technical Skills (Computer, Website Development, etc.)
Twitter Name: Facebook Name: Instagram Name:
Please check all the areas you would be interested in working on for this chapter:
P.O. Box 30784, Memphis, TN 38130
ð Chairing a Committee
ð Holding a chapter office in the future
ð Running for National Office
ð Contributing to our chapter’s scholarship fund
ð Contributing to the ASU Foundation
P.O. Box 30784, Memphis, TN 38130
Committees:
P.O. Box 30784, Memphis, TN 38130
ð Membership
ð ASU Student Recruitment
ð Communications/Media
ð Activities/Fundraising
ð Scholarship Recipient
ð Scholarship Banquet
ð Hospitality
ð Courtesy
P.O. Box 30784, Memphis, TN 38130
Signature: ______Date: ______