YES! I want to join the UCO Alumni Association
p Recent Graduate individual membership - dues =
$25.00 (Offer good for one year from date of graduation)
p Blue Annual individual membership - dues
= $50.00
p ”Broncho for Life” individual membership – dues = $750.00
p Upgrade to “Broncho for Life” - upgrade dues = $500
(upgrade offer valid for current Life Members only)
Mr. Mrs. Ms. Miss
_______________________________________________________________________
Last First Middle Maiden
Permanent Mailing Address
_____________________________________________________________
City
_____________________________________
State __________ Zip Code
___________________
Home Phone (______)_________________________ E-Mail ____________________________________
Date of Birth
____________________________ Social
Security # (optional)
______________________
Degree/Date of Degree _____________/_________
Major/Minor ____________/____________ Name on student
records _______________________
Spouse
information (If he/she is a graduate of UCO):
Name
________________________________________________________________________________________________________________
Date of Birth __________________________ Social Security # (optional)
_______________________
Degree/Date of Degree _____________/_________
Major/Minor ___________ /___________ Name on
student records ___________________________
(If
different from current name)
Payment
Information:
p
Check Enclosed p Visa p MasterCard Amount $________________________
(Please make check payable to UCO Alumni
Association)
Cardholder’s Name as it appears on credit card
_________________________________________
Credit Card # ________ / ________ / ________ /
_______ Expiration
Date __________________
Cardholder Signature (required
for credit card payment) __________________________________________________
Watch preference
(For “Broncho for Life” members only – check one) pLady’s Fossil
Watch pMen’s Fossil
Watch
To join the UCO Alumni Association, simply print and
fill out this reply form and send your membership dues payment to:
UCO Alumni Association
(Please make
checks payable to: UCO Alumni Association)
Thank you!