Membership Form

G. W. Carver High School Alumni Association

1941 - 1971
Membership Form

(Scroll down the page for raffle ticket, band, and glee club information.)

Print this form and mail to Dornella Joyner at the address below.

G. W. CARVER ALUMNI ASSOCIATION
Membership/Contribution Form

The Carver Eagle

Name: ______________________________________________________

Address: ______________________________________________________

City, State, Zip _________________________________________________

Phone: (___)_______________________ E-mail ____________________

_________ $20.00 Annual Membership Dues

_________ $50.00 Banquet

_________ $10.00 Picnic

_________ $Total Amount Enclosed

Make checks payable to G.W. Carver Alumni Association

Mail this form along with your payment by June 20, 2010

To: Dornella Joyner

909 Long Avenue

Rocky Mount, NC 27801

252-442-7028

_______________________________________________________________________________________________

Raffle Fund Raiser Tickets

$2 each 3 for $5

Total Tickets_____

Total $ Amount Enclosed______

First Prize - Quilt

Second Prize - $100

Third Prize - $50

You do not have to be present to win!

_____________________________________________________________________________________________

Were you in the G. W. Carver

Band Yes___ No____

Glee Club Yes____ No___

Basketball Team Yes___ No____

Would you like to participate in the 2011 G.W. Carver Alumni Parade. Yes___ No___

Name_________________________ Phone ______________