MELVINDALE HIGH SCHOOL


ALUMNI ASSOCIATION REGISTRATION FORM

 

NAME:     _____________________________________________________________________________________


        	 First                		 Initial      		 Last                        		Maiden


ADDRESS:  _____________________________________________________________________________________





CITY:     __________________________________   STATE:  _____________________   ZIP:  __________





PHONE:    _________________________       GRADUATION YEAR:   ______________________________________








EMAIL ADDRESS:  ________________________________  


Would you accept the newsletter via email to save postage costs?    Yes  _____    No  _____





_____   CHECK HERE IF APPLYING FOR HONORARY ALUMNI MEMBERSHIP


MELVINDALE ALUMNI LAPEL PIN, MEMBERSHIP CARD, SPORTS SCHEDULE


AND SEASONAL NEWSLETTER WILL BE MAILED TO THE ABOVE ADDRESS


PLEASE CHECK ANY OF THE FOLLOWING INTERESTS:


_____  Yes, I would like to contribute in some way as an Alumni.


_____  Yes, I would like to be on the Alumni Mailing List.


_____  Yes, I would like to be contacted for Summer Golf Outing.


_____  Yes, I would like to be contacted for Homecoming Alumni Activities.


_____  Yes, I would like to be contacted for Alumni Spring Banquet.


_____  Back to School Alumni Open House. 


_____  Assisting in organizing Alumni functions. 


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TAX DEDUCTIBLE ANNUAL DUES $35.00


PLEASE MAKE CHECKS PAYABLE TO:  MELVINDALE HIGH SCHOOL


MAIL REGISTRATION FORMS TO:		Mario D'Herin


				14460 Woodside


				Livonia  MI   48154


				313-464-8355


Any additional information - contact Mark Dabiero  (313) 441-6715   


++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++


MELVINDALE HIGH SCHOOL ALUMNI ASSOCIATION


MAKE CHECKS PAYABLE TO:   MELVINDALE HIGH SCHOOL


								$_______________________


								   Total amount enclosed


Retain this slip for a tax deductible receipt