Sperry Alumni Association - Membership Registration Form

Please complete and submit the membership registration form below. The fields that are marked with an * are required. If your browser does not support forms, please complete and mail the printable registration form.

Please sign me up as a member of the Sperry Alumni Association.

Last Name:             *

Maiden Name:

First Name:             *

Name of Spouse:

Postal Address:       *

City:                          *

State: *

Zip:                            *

Telephone:              --

E-mail Address:

Year of Graduation:       Non-Graduate

Other than myself, I am paying dues for the following individuals:

#1 - First Name:

       Last Name:

       Maiden Name:

E-mail Address:

Year of Graduation: Non-Graduate

#2 - First Name:

       Last Name:

       Maiden Name:

E-mail Address:

Year of Graduation: Non-Graduate

#3 - First Name:

       Last Name:

       Maiden Name:

E-mail Address:

Year of Graduation: Non-Graduate

Check all of the following that apply:

Include my personal information in the Alumni Association's Online Directory.

Do not include my personal information in the Alumni Association's Online Directory.

Comments and/or Questions:

Please remember to mail your membership dues of $10.00 per member to:
Sperry Alumni Association, P.O. Box 417, Sperry, OK 74073

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