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Howard University Alumni Association
Membership Form

Please complete the form below and mail the printed version to:
   Howard University Alumni Association
   607 Howard Place, NW
   Washington, DC 20059

You may also fax the completed form with your credit card payment to:
(202) 667- 0839

For further information, please call (202) 806- 5857.

(To print out this form after you have completed it, press CTRL+P.)


Name:

Maiden:

Address:
City: State: Zip:

Telephone Numbers

Home:
Business:
Email:

Degree(s):
Major(s):
Year Graduated:

Graduate    Former Student    HU Faculty/Staff


HUAA Annual Dues:
$35 per person for one year, and $105 per person for three years
Make check or money order payable to Howard University Alumni Association (HUAA)

Check Type of Payment:

Visa    MasterCard    American Express    Check/Money Order

Credit Card Number:    Exp. Date

Signature:    Date: