Cal Alumni Club of New York

CACNY 2009 Membership Application

Send form and check payable to “CACNY” to: CACNY Membership, c/o Allison Tomlinson, 2600 Netherland Avenue, Apt 2903 in Riverdale, NY 10463; Payment can also be made via PayPal ("Send Money" to calnewyork@gmail.com & your application to our g-mail address)

Name:
Class Year(s):
Degree(s):
Address:
City:
State:
ZIP:

Daytime Phone:
Evening Phone:
Email Address:

Current Employer or School Affiliation:

Are you a New Member?
Or Renewing Member?

I would like to become a CACNY member:
$20 for 2008 New Graduate 1-Yr Membership
$25 for 1-Year Membership
$45 for 2-Year Membership

I would like to donate to the operation of CACNY:
Add $50 for the operation of CACNY
Add $100 for the operation of CACNY
Add ____ for the operation of CACNY

I would like to donate to the Scholarship Fund:
Add $50 for Scholarship
Add $100 for Scholarship
Add ____ Scholarship

TOTAL AMOUNT INCLUDED: _____________