Membership Application – Fairmont Heights High School Alumni Association, Inc.

MEMBERSHIP APPLICATION

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MEMBERSHIP STATUS

PURPOSE

DATE SUBMITTED

NAME:

GRADUATING CLASS:

DATE OF BIRTH

Street address

City

State

Zip code

HOME PHONE

EMAIL

CELL PHONE

SOCIAL MEDIA

PREFERRED CONTACT

OTHER PREFERRED CONTACT

Membership dues

TYPE OF MEMBER

Type of Member Affiliation

DONATION

Special (Specify)

Please join one of the committees listed below. Refer to website for committee function.

P.O. Box 6753, Capitol Heights, MD 20791-6753

HONORING THE PAST…BUILDING A LEGACY FOR THE FUTURE!