Pass Christian High School Alumni Association
Membership Application
Annual Dues $20 per member
* Coverage period is from April 1st of the current year through March 31st of the
following year

__________________________________________________
Member #1:
Member Name

Maiden/Middle Name
Class Year

Contact Information:
Contact Address
City State Zip:

Email:
Phone Number

Check the boxes applicable below:

I would like to receive email notifications/newsletterI would like to help with planning of annual reunion celebrationI would like to serve on the alumni board or committees

__________________________________________________
Member #2:
2nd Member Name

Maiden Name
Class Year

Contact Information:
Contact Address
City State Zip:

Email:
Phone Number

__________________________________________________
Check the boxes applicable below:

I would like to receive email notifications/newsletterI would like to help with planning of annual reunion celebrationI would like to serve on the alumni board or committees

__________________________________________________
Scholarship Donation:
$0$10$25$50$100Other
Donation Amount: Donation Amount

Is this donation in memory of someone?
NoYes

In Memory of:

Class Year

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Annual Dues $20 per member
* Coverage period is from April 1st of the current year through March 31st of the
following year

You can pay your Membership dues by mail, at check-in at the reunion celebration or via PayPal under the Membership Dues page.
Please note: we do not take credit cards except via PayPal.

Payment Option:
UndecidedMail Check/Money OrderAt Reunion CelebrationPayPal (Click button below)