Century Club Membership Form

Century Club Membership Form
The Century Club is the driving force for future Alumni Association projects. Members pledge to give a $100 gift annually. The funds go toward the general operation of the Association, chapter building opportunities, campus improvement projects and other alumni projects.
Membership Type

NEW MembershipRenewal Membership
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Payment Method

Check (please make payable to Southeastern Foundation) Mailing address is 425 W. University Blvd, Durant, OK 74701, Attn: Alumni Relations OfficeCredit Card (please contact the Alumni Office to process your credit card)
Should be Empty: