Form
NCCU Raleigh-Wake Membership
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Please include me in the chapter's private address book.
Please Select
Yes please
No thank you
Date of Birth
-
Month
-
Day
Year
Date
Date of Graduation
-
Month
-
Day
Year
Date
Major
Date of Graduation (second degree)
-
Month
-
Day
Year
Date
Major (second degree)
I authorize the North Carolina Central University Raleigh-Wake Alumni Chapter to utilize my image from events that I may attend on the Chapter's Website.
I opt in
I opt out
Are you interested in any of the following sub-committees?
Social
Scholarship
Membership
Program
Audit
Amenities
I am currently a Lifetime Member of the North Carolina National Alumni Association.
Yes
No
My Products
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next
( X )
New or Renewing Membership
I am a new member and I have never been a member of the NCCU Raleigh-Wake Alumni Chapter.
$
45.00
National Alumni Dues
I am either a new or current member of the National Alumni Association. In order to be recognized on a National level, this must be paid as well.
$
50.00
One & Done Renewal
This membership will cover your Local & National Dues with a contribution to the school in your name.
$
100.00
All-in-one
This membership will cover your Local & National Dues, $100 Eagle Team Pledge and a contribution to the school in your name.
$
200.00
Eagle Team
NCCU Raleigh-Wake Alumni Chapters Annual Giving Program. $100 Pledge/100% Participation
$
100.00
CashApp/Mail-in Payment
Select this option if you will be mailing in your payment or submitting it via CashApp
$
Free
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