Katy/West Houston A&M University Mother S Club

KATY/WEST HOUSTON AGGIE MOMS CLUB 2017-2018 Membership Form

Membership Information: New____ Renewal____ Sustainer____

Name Birthday (mm/dd) Spouse’s Name

Address

City State Zip Code

Home Phone Cell Phone

E-mail Address (print clearly)

CURRENT STUDENT INFORMATION Name Corps unit TAMU Class of:

Name Corps unit TAMU Class of:

FORMER STUDENT INFORMATION (Immediate Family; Self, Spouse, Children) Name Texas A&M Class of:

Name Texas A&M Class of:

CHECK YOUR PARTICIPATION INTERESTS Officer/Board _____ Committee _____ Special Events _____ Refreshments _____

I authorize the use of my photograph and name for club purposes such as website, newspaper, scrapbook, etc.

Signature______Date ______

INCLUDE THIS FORM WITH YOUR CHECK AND BRING TO THE GENERAL MEETING OR MAIL TO: Caryn Reddell 4903 Cloudcliff Ln Katy, Texas 77494

2017-2018 Dues: Accounting Purposes only New & Renewal: $25 Sustainer: $15 Cash______Check #______Make Checks Payable to: KWHAMC Date Paid/Processed: ______

Database Updated: ______