NCCU Alumni Association Durham Chapter Membership Form
Durham Chapter Membership Application
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Date *
MM
/
DD
/
YYYY
Membership *
Title
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First Name *
Last Name *
Address (include City, State, and Zip Code) *
Primary Phone Number *
Email Address *
Degree(s) *
Graduations Date(s) *
Your Committee(s) of Service Interest
Constitution
Program Planning
Public Relations
Nominating
Membership
Scholarship
Finance
Fundraising
Standing Committee
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Additional Committee(s) of Service Interest
Awards & Recognition
Civic Engagement & Advocacy Committee (CEAC)
Student Engagement, Employment and Mentoring Committee (SEEM)
Bereavement
Golden Eagle Tea
Scholarship Banquet
Special Committee
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Membership
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Contribution to Mr/Ms Alumni Contest
Method of Payment
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Submit
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