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CENTRAL VIRGINIA ALUMNI CHAPTER SOUTH CAROLINA STATE UNIVERSITY MEMBERSHIP INFORMATION Form
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Email
*
Your email
Last Name:
*
Your answer
First Name:
*
Your answer
Maiden (if Applicable):
Your answer
Birth Date (MM/DD)
*
Your answer
Address:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Zipcode:
*
Your answer
Preferred Phone with Area Code:
*
Your answer
Primary Email:
*
Your answer
Spouse's Name:
*
Your answer
Child(ren):
*
Yes
No
Children's name
Your answer
Major/Minor:
*
Your answer
Degree:
*
BS
BA
Master's
PhD
Other:
Required
Year Graduated:
*
Your answer
COLLEGE/UNIVERSITY IF NOT SCSU:
Your answer
Campus Affiliations:
(Band, Military, Fraternity/Sorority, etc.)
Your answer
I want to be an active participant; I’m interested in the following committee(s):
Fund Development
Membership
Hospitality
Scholarship
Technology
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