BECOME A MEMBER…

 PERKINS ALUMNI AND FRIENDS ASSOCIATION

 PLEASE COMPLETE THIS FORM FOR MEMBERSHIP IN THE ASSOCIATION

Perkins Alumni & Friends Association Membership Levels

Basic Membership

Couples Membership

Patron Membership

$15 one year

$ 25 one year

$ 50 one year

 $45 three-year

 $ 75 three-year

 $150 three-year

 $75 five-year

 $125 five-year

 $250 five-year

Date:    _______________________________________

 

Are you ______ an ALUMNUS or ______ a FRIEND             If alumnus, YEAR OF GRADUATION______________

 

NEW MEMBERSHIP _____ or RENEWAL _____ If renewal, please update information below with any changes.

 

NAME (Last) ___________________________(Maiden) _____________________ (First)_______________________

 

HOME ADDRESS______________________________________________________________________________________

 

CITY______________________________ STATE______________ZIP__________ PHONE____________________

 

EMAIL ADDRESS______________________________________________________________________________________

 

PUBLISH EMAIL ADDRESS ON ALUMNI WEBSITE          ________YES _______NO

SPOUSE’S NAME____________________________________    PHS GRAD_______YES_________ (year)_____ NO

 

DID YOUR CHILDREN GRADUATE FROM PERKINS?   YES   NO

Please list names           _______________________    ________________________      ________________________

and year graduated

                                       _______________________    ________________________      ________________________

LIFE AFTER PERKINS:

WORK/OCCUPATION    ______________________________________________________________________________

 

SKILLS/INTERESTS      ______________________________________________________________________________

 

SCHOOLS ATTENDED           _______________________________________________________________________

or MILITARY EXPERIENCE    

                                                 _______________________________________________________________________

DEGREES ATTAINED______________________________________________________________________________________


Please send the complete membership form, along with your dues, to the address below.

 Make checks payable to Perkins Alumni and Friends Association

Perkins Alumni and Friends Association

PO BOX 259  Sandusky, OH  44871-0259