Penn State Alumni Association of Northern NJ

Mail your check made payable to “NNJ Penn State Alumni Association” and Membership form to:

Northern NJ PSU Alumni Association

C/O Barry Ellen

Treasurer

29 Connor Ave

Metuchen, NJ 08840

______Annual Single Membership ($15)

______Annual Family Membership ($25)

______Special 3-year Single Membership ($40)

______Special 3-year Family Membership ($65)

Name

Class

Spouse/Children

Home Address______Apt#______

City______State______Zip______

Email Address______

Can you receive attachments such as our newsletter Yes No

Preferred Phone Number______(home/ work/ cell)

Alternative Phone Number______(home/ work/ cell)

What events would you like to receive information about?

_____ Happy Hours (Hoboken or Morristown or ______)

_____ Socials (for singles or families or both)

_____ THON

_____ Summer Freshman Send off Picnic

_____ Other

Would you like to be involved with a Committee?

____ Membership

____ THON

____ Community Outreach

____ Public Relations