Title: __ Mr. __ Mrs. __ Miss __ Ms. __ Dr. __ Rev. __ Sr.
First Name: _______________________________________ Middle Init.:______
Maiden Name: _____________________________________
Last
Name:_______________________________________ Class Year:________
Street Address:__________________________________________________________
City:_________________________________ State:_________ Zip:____________
Home
Phone:_____________________ Email Address:_________________________________
| Dues paid for: |
__ 1 Year ($5)
|
__ 2 Years
($10)
|
__ 3 Years ($15)
|
__ 4 Years ($20)
|
|
|
__ 5 Years ($25)
|
__ Other:
|
___ Years @ $5/Year
|
|
Spouse’s Name:(If Camden Alumni, include Class Year, if female Alumni, include include maiden name)
_____________________________________________________________________
Your
birthdate: _____- ____ -__________
Month Day Year
Temporary Address:
(If you have a temporary address, either for the Winter or Summer,
please indicate it below.)
Temp Street address: _______________________________________________
Temp City:__________________________ Temp
State:______ Temp Zip:_____________
Temp Phone Number:________________________________________
Active
Months: Jan Feb Mar Apr May Jun
Jul Aug Sept Oct Nov Dec
Your
parent’s name(s), if Camden Alums (include graduation year, also):
Name:___________________________________________________ Year: _________
Name:___________________________________________________ Year:_________
Current annual dues are $5.00 per year per person. Payment can be made for multiple years. Send your dues payment
to:
Camden Alumni Association
Scott Souva, Registrar
10154 Florence Hill Road
Camden, NY 13316
If paying by check, make payable
to Camden Alumni Association.
Camden Alumni Association
Membership Form
Membership Definition: Any person who graduated from Camden Schools, or has been certified
as an alternate diploma holder (e.g. GED, Military, etc.) is automatically a member of the Camden Alumni Association. To become anActive Member you need only pay annual dues. Active members, only, have the privilege of voting in Association elections.
Membership
Year: The membership year commences at the Annual Meeting and Banquet, and expires at the next annual Meeting and Banquet. Membership
expiration is shown on mailings of the brochure and ballot in the address panel near your name.