California State University, Fresno

Fresno State Alumni Membership Application Form

YES, sign me up as a member of the Fresno State Alumni Association so I can receive my new membership benefits.

(* = required field)

*First Name

*Last Name

Maiden Name

*Address

*City

*State

*Zip Code

*Country

*Home Phone Number

Work Phone Number

*Email address

*Birth Date

Month Day Year

Fresno State Major

Degree

Graduation Date

(If applicable)

Joint Name

(If joint member)

Graduation Date

I am interested in receiving e-mail updates from Fresno State's Alumni Association.
(Your name will not be provided to other organizations nor mailing lists.)

*Membership Level

Fresno State Alumni Association Chapters (Optional)

Single Membership to a chapter is:	$10 per chapter each year.
Joint Membership to a chapter is:	$20 per chapter each year.
LIFE Single Membership to a chapter is:	$100 per chapter for LIFE.
LIFE Joint Membership to a chapter is:	$200 per chapter for LIFE.

African American	Band	Business
Chicano	Comm. Disorders	Engineering
Education	EOP	Kinesiology
Mass Communication/Journalism	Music	Nursing
Social Sciences	Social Work	Nu Alpha Kappa

All Memberships to the Armenian chapter:

$25 each year/life.

Armenian

Student Scholarship Donation

I would like to contribute $ to help a current student today.

Total Amounts

Membership Level	$
Alumni Association Chapters	$
Student Scholarship Donation	$
Total Amount to be Charged	$

Method of Payment

*Card Type	American Express MasterCard Visa
*Credit Card Number

*Expiration Date	Month Year

*Name as it appears on credit card

Please only click on submit once, additional submissions
may cause your credit card to be charged more than one time.