Image
Membership # _______
 
The BHS Alumni Association, Inc.
Membership Application Form
(Cut, Copy & Paste As A WORD Document; Keep a Copy For Your Records)
 
                                                                                                                       
_____________________
Today's  Date

                                                            
                                                               
Please type or print legibly and mail to the address below:
 
(Please circle title Dr./Mr./Mrs./Ms.)
Name of Applicant (include maiden name):_______________________________________________________
 
Mailing Address: 

___________________________________________________________________________
                         Street                                                             City                        State                 Zip
 
â–¡ Alumni    Class of ______                â–¡ Non Alumni
 
Phone: Work:   (       ) _______________________    

Cell:    (       ) _______________________  

Home: (       ) _______________________   

E-mail address: _________________________________________
 
Birth date: ________________________________                           
 
Occupation: ________________________________________________________________________________
 
Spouse: Dr./Mr./Mrs. ________________________________________________________________________
 
Did he or she attend BuchtelHigh School?     ž Yes       What year? _____      ž No   
 
Number of Children/Age (Optional) ________/________
 
Please check the appropriate membership level:
 
â–¡    BuchtelHigh School Alumni Association Membership - $25.00
â–¡    Associate Membership - $25.00
â–¡    Lifetime Membership Scholarship Endowment - $250.00
 
The Buchtel High School Alumni Association has permission to list the above information in the Membership
Directory   â–¡ Yes         â–¡ No  
 
The Buchtel High School Alumni Association has permission to post your e-mail address on the Alumni Association Web Site?   â–¡ Yes         â–¡ No
 
Make checks or money order payable to: Buchtel High School Alumni Association, Inc.
Send to: P.O. Box 22156     ATTN: Scholarship Endowment Fund/Membership
Akron, OH 44302-2153
 
 
Mission Statement
 
The Buchtel High School Alumni Association, Inc. is committed to the global success of BuchtelHigh School through academic programs, scholarships and athletics. We are strongly dedicated to the pride, success, and excellence of the Buchtel Cluster Community.
 
www.gogriffs.net
 
For internal use only:
â–¡ Cash    â–¡   Check # _______    Money Order # _________________
â–¡ New     Ã¢â€“¡ Renew      

Website maintained by SLSnet Biz 330.573.0247