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The Annual Member Online Membership Form
Your Information
*Salutation*First NameMI*Last NameMaiden Name
*Country
*Address Line1
Address Line 2
*City
*State
*Zip
*Please enter at least one phone number
Home Phone Work Phone Cell Phone
*E-Mail Address
What is your relationship with the University of Memphis Please check all that apply.
Alumna/us
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Other
I may be known to the University of Memphis by another name
I attended the University of Memphis from (YYYY) to (YYYY) to
Additional Information (Degrees, Awards, Organizations, etc.)

Select your areas of interest or involvement from the list of Clubs & Chapters below:
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Work Information
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Country
Address
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Joint Member Information
Check if you would like to add a joint member
SalutationFirst NameMILast NameMaiden Name
Relationship
E-Mail
Additional Information
Billing Information
Check if Billing Address is same as the Contact Address
*Full Name
*Billing Country
*Billing Address Line1
Billing Address Line 2
*City
*State
*Zip