CHS Alumni Membership Form
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Lifetime Membership
$
30.00
Quantity
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Item subtotal:
$
0.00
Donation
$
5.00
Quantity
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Item subtotal:
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Full Name
First Name
Last Name
What class were you in?
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Contact Number
Is mailing address same as billing address?
Yes
No
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Card Expiration
Security Code
Please click one of the PayPal options to complete payment and
submit
the form.
Submit Order
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