Membership

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1.

Ship To

First Name*

Last Name*

Spouse's Name

Address*

City*

State*

Postal Code*

Country*

Email*

Home Phone*

Cell Phone

2.

Auburn Graduation Year

3.

Member Auburn Alumni Association (AAA) ?

	Yes
	No

4.

Family Member Attending Auburn?

	Yes
	No

5.

Type Membership

	Single $20.00
	Family $35.00

6.

How did you learn of the Cullman County Auburn Club (CCAC) ?

7.

Would you like to be considered for a Committee position?

	Membership
	Scholarship Dinner
	Fall Picnic
	Relay for Life
	Cullman Co. Fair Booth

8.

Would you like to be considered for an Officer position?

	Pres.
	VP
	Sec.
	Treas.

9.

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Ship To

Auburn Graduation Year

Member Auburn Alumni Association (AAA) ?

Family Member Attending Auburn?

Type Membership

How did you learn of the Cullman County Auburn Club (CCAC) ?

Would you like to be considered for a Committee position?

Would you like to be considered for an Officer position?

Suggestions for growth / activities / fund raising / etc

Spirit of Auburn Card!

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