Do not pay if you are Honorary, Lifetime, Permanent Block

 C members (age 80 and over) or 2014 Free Graduates

 

2015 APPLICATION FOR MEMBERSHIP

WITH THE

USC ASSOCIATION OF LETTERMEN

 

Please select one of the options below:

 

______Enclosed is $50.00 (if paying BEFORE February 28, 2015)

 

______Enclosed is $60.00 (if paying AFTER February 28, 2015)

 

______Enclosed is $750.00 for Lifetime Membership

 

Today’s Date:____________________________

 

Name_________________________________Spouse______________

 

Address___________________________________________________

 

City_______________________State____________Zip____________

 

Sport____________________________

Year (s) Lettered________to__________

 

Employer__________________________________________________

 

Occupation_________________________________________________

 

Phone_________________________   Cell ________________________

 

E-Mail Address___________________________________


Date of Birth___________________________

  

______Check  ____Visa  _____Mastercard   ____Discover  ____American Express

 

Check No.___________

 

Credit Card#___________________________________  _Exp. Date_____/_____

3 digit Security Code on back of card_____

 

Print Name_________________________________________________

 

Signature___________________________________________________

 

Make check payable to:  USC Association of Lettermen

Mail to:  Jane McManus

             2 Rollingwood Hills Court

             Blythewood, S.C.  29016









































































































                                                                                                                                         















                                                       







                                        

 









































































































































































































































































































































































































































































































  











 

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