VUUNAA-CLT Membership Form

MEMBERSHIP FORM

Fiscal Year 2025-2026
I am a:
To be completed by all members:
Name

PrefixFirst NameLast NameSuffix
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Number

Area CodePhone Number
Cellular Number

Area CodePhone Number
E-mail
Change in Contact Information
To be completed by new members only:
If you were referred by an active Charlotte Chapter member, please enter their full name here:
Are you an alumnus?
Birthdate

MonthDayYear
Date
Maiden Name
Program of Study
Class Year
Greek Affiliation
Church Affiliation
Pastor's Name
Is your pastor an alumnus?
Church Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Website
MEMBERSHIP SURVEY

(To be completed by ALL members)
How do you prefer to receive news and/or announcements from our organization? (Check all that apply.)

Other
There are many ways in which members can use their talents, skills, and abilities to help advance the work of VUUNAA – Charlotte Chapter. Which of your talents, skills, and/or abilities would you be willing to share with the Chapter and how? (You may list more than one.)
Are you interested in serving on any of the following committees? (Check all that apply.)
Over the next year, what do you hope to gain from your membership with VUUNAA - Charlotte Chapter?
Over the next year, what activities/initiatives would you like to see VUUNAA - Charlotte Chapter participate in or organize?
Please indicate the highest level of education completed.
In which industry are you currently employed?
Name of Industry
Other:

Other
Do you own a business?
If yes, what is the name and nature of your business?
Electronic Signature
By typing your full name in the box above, you acknowledge the information entered in this online form is accurate.
Date

MonthDayYear
Date
Membership Categories
Fiscal Year
I am paying...
prevnext( X )
1 Year Alumni Membership - Charlotte Chapter ($50 for dues + $2 online payment fee)$52.00

1 Year Family & Friends Membership - Charlotte Chapter ($50 for dues + $2 online payment fee)$52.00

1 Year Alumni Membership - National Association ($50 for dues + $2 online payment fee)$52.00

1 Year Supporter Membership - National Association ($25 for dues + $1 online payment fee)$26.00

Lifetime Membership - National Association ($1000 for dues + $30 online payment fee)$1,030.00

Lifetime Membership (Installment Plan) - National Association ($250 installment + $8 online payment fee)$258.00

Total $0.00
Should be Empty:

MEMBERSHIP FORM

To be completed by all members:

To be completed by new members only:

MEMBERSHIP SURVEY

Membership Categories

I am paying...*

I am paying...