Post Office Box 72212 - Durham, North Carolina
27722
E-mail: NCCUsmbc@yahoo.com
Application of
Membership
Date:_____________________________________
MR.() MS.() MRS.() DR.() REV.()
NAME:_____________________________________
____
________
ADDRESS: _________________________________________________
CITY:_____________________________________
STATE:_________________________
Zip Code:_____________________________
Home Telephone:___________________________Work:_________________________
E-mail Address:_____________________________________
Personal Web Page: http://__________________________________________
Graduation Date(s):_______________________Degree(s):____________
Are You A: New Member () - Renewing Member () - Life Member () - Student Member () - Other Type Member ()
Student Recruitment () | Fundraising () | Club Membership () | Club Social Activities () |
Finance () | News Letter () | Scholarships () | Band Concerts () |
Dinner Dance () | Public Relations () | Alumni Band () | Band Logistics () |
Other Interest () |
Basic Membership Dues: | $25.00 | Per Year | () |
Patron Member: | $100.00 | Per Year | () |
Band_Wagon Member: | $250.00 | Per Year | () |
Life Patron Membership: | $500.00 | Life Time | () |
Student Member: | $10.00 | Per Year | () |
*SPECIAL CONTRIBUTION*
I Would Like To Make A Special Scholarship Contribution In The Amount Of: $______________, IN Support of the NCCU Sound Machine Bands.
I would like to Purchase or Donate A Band Uniform(s) or the following type(s) of Musical Instrument(s) for the NCCU Bands.
_________________________________________________
Please Make Your CHECK or MONEY ORDER Payable To:
Sound Machine Booster Club
Durham Chapter - NCCU Alumni Association (written on the check's MEMO Line)
Or, if you prefer, you can make your CHECK or MONEY ORDER Payable To:
The NCCU Foundation,
c/o Sound Machine Booster Club (written on the check's MEMO Line)
![]() You May Also Pay Your SMBC Contribution OnLine Directly To Our NCCU Foundation Account
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To Pay Your SMBC Membership Dues or Band Contribution OnLine |
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News Letter () | Internet () |
News Media () | Other Alumni () By Whom: ________________________(Please Specify): |
For Additional Information, Please E-mail us at: NCCUsmbc@yahoo.com
Revised: 07-31-2004