MEMBERSHIP APPLICATION
INSTRUCTIONS:
- Print out this page
- Choose your membership level
- Enter your other information
- Mail this form and a check for the amount indicated of the membership level chosen to the address at the bottom of this page
Choose Your Membership Level:
YOUR MEMBERSHIP IS VALID FOR ONE YEAR
☐ BASIC $25.00
☐ PATRON $50.00
☐ BENEFACTOR $100.00
☐ BASIC $25.00
☐ PATRON $50.00
☐ BENEFACTOR $100.00
Tell Us About Yourself:
Last Name_____________________________________________________
First Name_____________________________________________________
Maiden Name (if applicable)________________________________________
Graduation Year___________
Mailing Address
street_____________________________________________
city, state__________________________________________
zip code___________________________________________
E-Mail Address__________________________________________________
E-Mail addresses are used solely for Alumni Association business
Please Consider a Donation:
SCHOLARSHIP FUND $_____________
JOURNAL RESTORATION PROJECT $____________
JOURNAL RESTORATION PROJECT $____________
Send This Form and Check to:
BARRINGER HIGH SCHOOL ALUMNI ASSOCIATION, INC.
P.O. BOX 51
ESSEX FELLS, NJ 07021
P.O. BOX 51
ESSEX FELLS, NJ 07021