Cal State L.A. Alumni Association

Alumni Association Membership Form
"The Gateway to Expand Your Cal State L.A. Alumni Network"


	JOIN	Become a member today and begin taking advantage of your membership privileges!

	RENEW	Renew your membership before it expires. This is a terrific option for current members allowing us to conserve resources (no stamps or paper) & serve you better!

Personal Information:

Prefix:
First Name:
Middle Name:
Last Name:
Last name at graduation (if different):
Birthdate:	mm/dd/yyyy

Home Address:
City:
State:
Zip Code:
Phone:
E-Mail:

Joint Member Personal Information (if applicable):
Prefix:
First Name:
Middle Name:
Last Name:
Last name at graduation (if different):
Birthdate:	mm/dd/yyyy
Phone:
E-Mail:

Tell Us Your CSULA Degree Information:

1) Graduation Year:

Degree Earned:

Major:

2) Graduation Year:

Degree Earned:

Major:

3) Graduation Year:

Degree Earned:

Major:

Degrees earned outside CSULA:

Tell Us Your Business Information:

Employer/Company:
Your Title:
Business Address:
City:
State:
Zip Code:
Business Phone:
Business E-Mail:
Prefer mail sent to:	Home Business

Redeem Promotion Code:

Enter Code:

Network Memberships

Business Alumni Network

Education Alumni Network

Engineering Alumni Network

Entertainment and the Arts Alumni Network

Nursing Alumni Network

Alumni Networks offer an array of educational, career oriented and social programs... they also provide you with the opportunity to "NETWORK" with fellow alumni!

*Annual Memberships*
	Annual Individual	$40
	Joint (2 people)	$60
	Senior (Over 60)	$30
	Recent Graduate (within 1 year)	$30
	Current Student (SAA)	$15

*Life Memberships*
	Life Individual	$450
	Life Joint	$700
	Life Senior (Over 60)	$300
	New Graduating Senior	$275

Select A Payment Method:

Personal Check	(make check payable to the CSULA Alumni Association)
Credit Card	(your credit card information will NOT be sent over the internet)
	VISA MasterCard American Express
	Card Number
	Expiration Date

Print and Mail this form to:
CSULA Alumni Association
Alumni Center
5154 State University Drive, U-SU 102
Los Angeles, CA 90032

Or Fax to : (323) 343-6433