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Annual Dues Drive Form

July 1, 2008 - June 30, 2009

Please complete the form below, print it off, and mail it along with your check made payable to the WVU School of Pharmacy Alumni Association to West Virginia University School of Pharmacy Alumni Association, 1136 Health Sciences North, P.O. Box 9502, Morgantown, WV 26506-9502.  Thank you for your support.
Regular Annual Dues:   Lifetime Dues:   Retired Alumnus Annual Dues:
Single: $50 Single: $500  $25 per person 
Couple: $75 Couple: $750
Mortar & Pestle Club:
Last year alumni members of the Mortar & Pestle Club provided $2,685 in additional scholarship money, $2,390 to support student travel to national meetings, and $1,095 to support student travel to state meetings.  Students greatly appreciated this increased support.  Yes- I would like to join the Mortar & Pestle Club (open to annual & lifetime members) to provide additional support for specific programs.  These monies are in addition to my annual dues.
Scholarships  $
Student participation at national meetings $
Student participation at state meetings $
Other ( )  $
 

Please specify

  
 

Total =

 $
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Home Phone:
E-mail Address:
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Work Address:
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