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
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.
_____ Advertising in the newsletter for a nominal fee.
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TAX DEDUCTIBLE ANNUAL DUES $35.00 RENEWAL IS ONLY $10!
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
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MELVINDALE HIGH SCHOOL ALUMNI ASSOCIATION
MAKE CHECKS PAYABLE TO: MELVINDALE HIGH SCHOOL
$_______________________
Total amount enclosed
Retain this slip for a tax deductible receipt