Whoops! There was a problem loading more pages. Retrying... 2015-2016 Alpha Phi Membership Form.pdf. 2015-2016 Alpha Phi
Alpha Phi Alumnae of Northern Virginia Membership Form First Name Maiden Name Last Name Address City, State, Zip Preferred Phone Number Email Occupation/Employer Birthday College Chapter (spell out – e.g., Theta Iota)
Initiation & Graduation Years Twitter Handle Instagram User Name New Member
yes
Would you like to receive a print version (instead of email version) of our newsletter?
yes
DUES Please select ONE of the following dues types: Local Dues
$40.00
Recent Graduates (within the past 2 years)
$20.00
50+ Year Members
$25.00
Voluntary additional support of the local chapter, if you wish:
ΑΦ Silver & Bordeaux Member TOTAL
Amount at your discretion $
By December 1, please submit: Membership form: Email your new or updated membership form to
[email protected] or if your information has not changed from last year, please simply send an email stating no change. Dues: May be paid either online at http://www.alphaphi-va.org/dues.asp or by check made payable to: Alpha Phi Alumnae of Northern Virginia in care of Lyndsay Kelsey, 4327 Ravensworth Road #512, Annandale, VA 22003
