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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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
Eagle Team
NCCU Raleigh-Wake Alumni Chapters Annual Giving Program. $100 Pledge/100% Participation
$
100.00
All-in-one
This membership will cover your Local & $100 Eagle Team Pledge towards scholarships.
$
145.00
Honorary Member
You might not have graduated from NCCU but you would love to be a part of the nest, this is the membership for you!
$
45.00
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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