MILBY ALUMNI ASSOCIATION

MEMBERSHIP APPLICATION  

Reply Form:                    To:   Milby Alumni Association 
                                                     P.O. Box 750813        
                                                     Houston, TX. 77275-0813

(Please Print)

NAME: __________________________________________

CLASS OF: ________

ADDRESS: _______________________________________

CITY: ___________________________

STATE: _________ ZIP CODE: ____________

PHONE: __________________

E-MAIL: _________________________________________

DATE ______________

Enclosed is $ ____.00 for membership ($10.00 Annual)

for Year(s) ________

Enclosed is $ ___.00  for $100.00 *

*Century Club membership (Lifetime membership)

Thank You for Joining the Milby Alumni Association

Your Contribution is the Life Blood of our Organization

  PLEASE PRINT THIS FORM AND MAIL IT. Thank you.