-- Mr. Miss Ms. Mrs. Dr. First Name Last Name
Pitt School Year

Address
City State Zip
Phone
Email
Employer
Job Title
Spouse Name
Spouse School (if Pitt Grad) Spouse Year  

Membership Type
Member Renewal
New Member
Information Update Only
Name(s) of other Pitt Alumni in Household
School Year
Are you a member of the University of Pittsburgh Alumni Association (PAA)?
Yes   No
What type of Club events would you like to see in the future?

How did you hear about the Pitt Club? (List Pitt Club member if referred)

Comments/Suggestions:

ANNUAL MEMBERSHIP DUES
Dues are $10 per alumnus or $15 per Pitt Family.
Annual Individual - $10   Annual Family - $15  2008 Graduate - $0

SCHOLARSHIP DONATION
Please consider making a donation to the Club's Scholarship Endowment Fund. Donations can be made in any amount and are tax deductible to the fullest extent allowed by law. More information on the Club's scholarship and how to make a donation to the endowment fund can be found here.

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