Carter Ex-Student's Association Membership Form 2010

Name: ________________________________________________

Email Address (if any): __________________________________

Mailing Address: _______________________________________________

City: ________________________  State: ___________________ Zip: _____________

Phone Number: ________________________________ Other: ___________________

Year Graduated from Carter-Riverside: __________________________

Birthday: _______________________________

Name & Year of relatives that attended CHS: _________________________________

_______________________________________________________________________

Please check one category for membership:

                     General Membership                   $5  -  $24                _______
                     Sustainer                                        $25 - $49                _______
                     Contributor                                    $50  -  $99              _______
                     Benefactor                                     $100 & above       _______

           All membership fees will be used for projects and activities that benefit Amon Carter-Riverside High School and its students.

Please make checks payable to:

Carter-Riverside Ex Student's Association

Please mail your check to:

Carter Riverside Ex-Student's Association
P.O. Box 7005
Fort Worth, TX 76111