Online Membership Form | University of South Alabama

Alumni Membership Form

Complete the form below:

* Fields are required.
* Name
* E-mail Address:

Address:
* Street:
* City:	* State: * Zip:
* Telephone:
Cell Phone

Personal Information:
Employer:
Title/Position:
Business Address :
Business Phone:
City:	State: Zip:

Spousal Information ( If USA Alumnus) : *only required if purchasing joint memberships
Spouse Name:
E-mail :
Cell Phone:

* Membership Options:
1 Year Membership	First Year Graduate $10
	Individual $35
	Joint $60
	Associate Individual Annual $40 (non-USA graduate)

Lifetime Memberships	First Year Graduate Lifetime $375 *first payment must be received within six (6) months of graduation date Pay in Full Five Annual $75 payments

	Individual Lifetime $500 Pay in Full Five Annual $100 payments

	Joint Lifetime $750 Pay in Full Five Annual $150 payments

	Associate Individual Lifetime $550 (non-USA graduate) Pay in Full Five Annual $110 payments

	Joint Associate Lifetime $800 (non-USA graduate) Pay in Full Five Annual $160 payments