Charlotte-Area FAMU NAA Membership Form

Charlotte-Area FAMU Alumni Membership Form
Are you renewing your membership or registering for the first time?*

RenewingRegistering for first time
Email (*enter email address using lowercase characters only*)*
Name

First NameLast Name
Membership Number
FAMU NAA Membership Number
Email2
example@example.com
Phone Number

Area CodePhone Number
Home Address
Home Address Line 2
City
State
Postal/Zip Code
Birthday
Month / Day
Employer Name
Job Title
Major
Class Year*
Graduation Month*
Interested in serving on a committee?

YesNo
Which Committee?
Membership Type
Spouse's Name

First NameLast Name
Spouse's Phone Number

Area CodePhone Number
Spouse's Email
example@example.com
Spouse's Birthday
Month / Day
Spouse's Employer Name
Spouse's Job Title
Spouse's Major
Spouse's Graduation Month
Spouse's Class Year
Membership Payment Preference*
You will be directed on how to pay on the next screen
Should be Empty:

Charlotte-Area FAMU Alumni Membership Form