<p>KATY/WEST HOUSTON AGGIE MOMS CLUB 2017-2018 Membership Form</p><p>Membership Information: New____ Renewal____ Sustainer____</p><p>Name Birthday (mm/dd) Spouse’s Name</p><p>Address</p><p>City State Zip Code</p><p>Home Phone Cell Phone</p><p>E-mail Address (print clearly)</p><p>CURRENT STUDENT INFORMATION Name Corps unit TAMU Class of: </p><p>Name Corps unit TAMU Class of:</p><p>Name Corps unit TAMU Class of:</p><p>FORMER STUDENT INFORMATION (Immediate Family; Self, Spouse, Children) Name Texas A&M Class of:</p><p>Name Texas A&M Class of:</p><p>Name Texas A&M Class of:</p><p>Name Texas A&M Class of:</p><p>CHECK YOUR PARTICIPATION INTERESTS Officer/Board _____ Committee _____ Special Events _____ Refreshments _____ </p><p>I authorize the use of my photograph and name for club purposes such as website, newspaper, scrapbook, etc.</p><p>Signature______Date ______</p><p>INCLUDE THIS FORM WITH YOUR CHECK AND BRING TO THE GENERAL MEETING OR MAIL TO: Caryn Reddell 4903 Cloudcliff Ln Katy, Texas 77494</p><p>2017-2018 Dues: Accounting Purposes only New & Renewal: $25 Sustainer: $15 Cash______Check #______Make Checks Payable to: KWHAMC Date Paid/Processed: ______</p><p>Database Updated: ______</p>