Please printout, complete and
send in this application in order to
become a current member of the Chapter.
Please also indicate your areas of
interest in the Chapter activities.
I am interested in the following
events:
[ ] Attending T.V. Football Parties
[ ] Attending Penn State athletic
events in MI
[ ] Recruiting at High Schools
[ ] Organizing/helping with a new event
[ ] Volunteering for the chapter's
community service
projects
[ ] Happy Hours
[ ] Golfing with other chapter members
[ ] Going to PSU for Homecoming Weekend
[ ] Chapter Dinners
[ ] Suggestions:
_____________________
____________________________________
I would like to become part of a
committee:
[ ] Membership
[ ] Students and younger members
[ ] Communications
[ ] Scholarship and Fundraising
[ ] Activities
[ ] Sports Programming
Enclosed please find my 2008
annual membership dues of (select one):
[ ] Single ($15.00)
(OR)
[ ]Couple ($20.00)
Chapter Scholarship Programs
[ ] Enclosed is my tax-deductible
contribution to the
Local LSF
Scholarship fund $_______________ (Please make separate check out to "LSF - PSAA Michigan Chapter")
[ ] Enclosed is my tax-deductible
contribution to the
PSU Endowed
Scholarship fund $_______________(Please make separate check out to
"Penn State University")
Name ____________________________________
Class Year ______________________________
Address ________________________________
_________________________________________
City _________________________________, MI
Zip _________________________-__________
Home Phone _____________________________
Work Phone _____________________________
Fax: __________________________________
Email Address:______________________________
Profession _____________________________
Major __________________________________
Employer/Business: ________________________
City __________________________________
PSU Fraternity/Sorority/
Affiliated Interest Group ______________
______________________________________
I prefer NOT to have my
[ ]address,
[ ] telephone number,
[ ]
e-mail address,
[ ] employment
information included in the chapter
directory.
Checks payable to PSAA - Michigan
Chapter.
I would like to receive chapter newsletter by
[ ] Regular US Mail
[ ] Email
Mail to: Bob Veres, 16688 Dunswood Dr, Northville, MI 48126-2312
