APPLICATION Membership/Renewal of Membership

Name    Year Graduated

Address

City     State     ZIP

Amount Enclosed $     Home Phone

Email     Work Phone

DUES SCHEDULE (Please check appropriate item)

Regular Members

$12.00 per fiscal year $-0- first fiscal year after graduation

Associate and Honorary Members

$12.00 per fiscal year, Associate Member $-0- Honorary Member

Lifetime Member

$12.00 for life (alumnus who graduated 50 or more years ago)

Print form, attach check and mail to:

St. Louis Alumni Association
916 Coolidge Street
Honolulu, Hawaii 96826