COLUMBIA UNIVERSITY CLUB OF WASHINGTON D.C.

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COLUMBIA UNIVERSITY CLUB OF WASHINGTON D.C., INC.
MEMBERSHIP APPLICATION OR RENEWAL FORM
2004

PLEASE FILL OUT AND PRINT THIS FORM, INCLUDE YOUR CHECK OR MONEY ORDER PAYABLE TO C.U.C.D.C. FOR THE APPROPRIATE AMOUNT AND MAIL TO :

CUCDC MEMBERSHIP
ATTN: SHEILA SUMMERS
4227 46th STREET N.W.
WASHINGTON D.C. 20016

SALUTATION:
MR.MRS.MISSMS.DR.ESQ.

FIRST NAME:

MIDDLE NAME:

LAST NAME:

YEAR OF GRADUATION OR ATTENDENCE:

SCHOOL ATTENDED:

E-MAIL ADDRESS:

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MAILING ADDRESS:

TELEPHONE:

PROFESSION:

EMPLOYER:

WORK TELEPHONE:

MEMBERSHIP TYPE:

GENERAL
one year $20
General Membership includes all program mailings, newsletters and reduced price for events.

CONTRIBUTING
one year $30
Contributing Membership includes all benifits of General Membership plus ability to bring a guest to Club Events at member prices!

ENCLOSED 2004 dues:
$

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WELCOME TO COLUMBIA UNIVERSITY CLUB OF WASHINGTON D.C.
WE APPRECIATE YOUR SUPPORT AND INVOLVEMENT.