LSU Alumni Association - Greater Houston Chapter Membership Form

Make checks payable to 'Greater Houston LSUAA' and mail with this form completed to:

                                    LSU Alumni Association of Greater Houston

                                    1775 St. James Place

                                    Suite 100

                                    Houston, TX  77056

Name:__________________________________________________________

Address:________________________________________________________

City, State, Zip:___________________________________________________

E-Mail:_________________________________________________________

Phone:__________________________________________________________

Single Membership ($20)_____                    Family Membership* ($30)_____

Additional Family Alumnus Members:__________________________________________

*Family Membership is for those who have multiple LSU alums in their household (i.e. spouses)