Print this form
and mail to:
Berlin High School Alumni Association
PO Box 276
Berlin, WI 54923
Donation and Membership Form
| Name: | ______________________________________________ | ||
| Maiden Name: | ______________________________________________ | ||
| Year of Graduation: | ______________________________________________ | ||
| Address: | ______________________________________________ | ||
| ______________________________________________ | |||
| State/Province: | _______________________ Postal Code:____________ | ||
| Country: | ______________________________________________ | ||
| Life
Membership @ $20.00 |
$_______________ | Donation (general) | $_______________ |
| Scholarship Fund | $_______________ | Table Fund | $_______________ |
| Total Amount Enclosed | $_______________ | ||
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