SAVANNAH STATE UNIVERSITY

NATIONAL ALUMNI ASSOCIATION

ATLANTA DOWNTOWN CHAPTER

HTTP://WEBPAGES.CHARTER.NET/SSUATL

MEMBERSHIP APPLICATION

Welcome to the Atlanta Downtown Chapter of the Savannah State University National Alumni Association. 

Please print the application and mail the completed application with your membership payment to

Alfred Berry Jr., Membership Chairman. 

Date: ___/___/___

Name _________________________________________________________________________________________

Address (include zip code)_________________________________________________________________________

Telephone# (Home) _______________________________

Home Email Address ______________________________

Year(s) Attended or Graduated From Savannah State University ______________

Place of Employment __________________________________________ Matching fund company (Y or N)________

Address of Employer (include zip code) _______________________________________________________________

Telephone # (Work) _______________________________ Email Address __________________________________

( ) New Member ( ) Renewal ( ) Transfer
( ) Option 1 - Annual Dues $50.0 (renewable each year)
( ) Option 2 - Life Membership Installment Plan (Includes Local Chapter Dues Per Year)
1st Year $187.00                     2nd Year $187.00                     3rd Year $186.00
Amount Paid ________ (  ) Cash   (  ) Check Ck.# ______
Payable to:                         SSUNAA Atlanta Downtown Chapter
Address:                             The Atlanta Downtown Alumni Chapter
	Alfred Berry, Jr - Membership Chairman
	165 Princeton Trace
	Fayetteville, Georgia 30214

Scholarship Contributions Are Tax Deductible