UA Hispanic Alumni Membership Form This beautiful UAHA bookmark will be mailed to you upon receipt of your membership fee and/or donation. Actual size: 1 3/4" x 2 3/4" Colors: Gold clip, Red and Blue Logo Annual Membership $35 Current UA Alumni Association Members — $15 (effective through December 31, 2007 • not tax-deductible per IRS regulations) Thank you! Your membership helps to support scholarship programs and services of the University of Arizona Hispanic Alumni. • To pay by mail with credit card or check, type in your information in the form below, then print and mail the completed form to: The University of Arizona Hispanic Alumni 1111 N. Cherry Ave., Tucson, AZ 85721-0109
New Member   Membership Renewal Associate Member (under 30 units) Name   Class year UA College Company   Title Address City   State   Zip Code Phone / Day   Evening E-mail   Annual Membership (not tax-deductible per IRS regulations) $ Additional tax-deductible gift to the UA Hispanic Alumni Scholarship Fund $ Total amount charged to your credit card $ Visa   MasterCard      Card Number   Expires   Check enclosed — Total Amount $   Make check payable to: UAF/UAHA   Thanks for your support of the University of Arizona Hispanic Alumni! For more information contact Oscar Lujan at 800-232-8278 or 520-626-9327. Last Update: 10/25/2007