2023 NCCU Raleigh-Wake Membership Form

Please note that none of this information will be shared with anyone outside of the chapter for solicitation purposes.

Name*

First NameLast Name

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Please include me in the chapter's private address book.*

Are you currently a business owner? Our chapter will be creating a business directory*

Date of Birth*

Date

Date of Graduation*

Date

Major*

Date of Graduation (second degree)

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 inI opt out

Are you interested in any of the following sub-committees? (select only two)

I am currently a Lifetime Member of the North Carolina National Alumni Association.*

YesNo

If you were referred by someone, please provide their name below.

My Products*

New or Renewing Membership Product Image

New or Renewing MembershipI am a new member and I have never been a member of the NCCU Raleigh-Wake Alumni Chapter.

$45.00

Eagle TeamNCCU Raleigh-Wake Alumni Chapters Annual Giving Program. $100 Pledge/100% Participation

$100.00

Chapter All-in-oneThis 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 PaymentSelect this option if you will be mailing in your payment or submitting it via CashApp

$ Free

Recent Under GraduatesAll recent under graduates are given a year of Free Dues from the Raleigh-Wake Alumni Chapter. This is granted based on your gradutaion date above.

$ Free

Total

$0.00

Membership Form

All national dues must be paid to the NCCU National Alumni Association. https://nccualumniassociation.salsalabs.org/newmemberrenewingmemberenrollment/index.html