Smith College Club of Philadelphia Membership Form
Our programs, events, and scholarships are funded by your membership dues. Please fill out this form whether you are a new or returning member to ensure that we have the most up-to-date information.
Your support is greatly appreciated!
Email address *
Alumnae at the 2015 Smith College Club of Philadelphia Faculty Talk
Contact Information
Please note that most of our club communications are done by email via the Smith College Alumnae Association. To ensure you receive our emails, please keep your information up to date at http://alumnae.smith.edu
First Name *
Your answer
Last Name *
Your answer
Smith Class Year *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
Phone number *
Your answer
Membership Dues
Please select your membership level below. Junior Membership offers the same benefits of a Regular Membership at a discounted rate for recent graduates. Annual memberships are valid for one year from the date of payment. Ivy Day Memberships are valid for three years from the date of payment.
Membership level *
Additonal Support (Optional)
Additional donations to support our Book Award Program for area high schoolers, our club operations, or the scholarship fund for Philadelphia-area Smithies are greatly appreciated. Please note: Contributions or gifts to the Smith College Club of Philadelphia are not deductible as charitable contributions.
Book Award Sponsorship Amount: ($20 sponsors one award)
Your answer
Supporting Contribution Amount:
Your answer
Philadelphia-area Scholarship Contribution Amount:
Your answer
Payment Method
Payment is gratefully accepted via PayPal on our website at phillysmithclub.com/membership or by sending a personal check to our Treasurer at: SCCOP Treasurer, 2300 Naudain St. Unit B, Philadelphia, PA 19146.
I am sending a total payment of... *
Your answer
I will submit my payment by... *
I want to get involved!
I would be willing to...
Please share any additional comments or suggestions here. Thank you!
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.