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MEMBERSHIP APPLICATION

Syracuse Alumni Club of Central Ohio

PERSONAL INFORMATION

Name:_____________________________________________________

Street Address:__________________________________
_____________________________

City/State/Zip:

Phone Number: ________________________________________


Email Address: ______________________________________________________

WORK INFORMATION
Current Employer _____________________________________ Job Title _________________________________

SYRACUSE INFORMATION
Year Graduated __________________________ Major / Degree _____________________________________

Check One:
____ $10 Full Member
____ First Year FREE (Recent Grads)

Please make checks payable to Syracuse Alumni Club of Central Ohio and mail membership dues to:
Ryan Stalzer
3516 Harrow Gate Court
Columbus, OH 43220
Email Club Treasurer Ryan Stalzer with questions: ryanstalzer@yahoo.com