Please PRINT THIS PAGE, complete, and return to:
Linda Hammerling, 125 Hitchcock Rd., Southington, CT 06489.
PLEASE PRINT CLEARLY:
Home telephone: ____________________________Work telephone:_____________________________
Email address: ________________________________________________________________________
(NOTE: The e-mail list is maintained locally, so you will not receive club e-mails unless
you provide your e-mail address! We do not share your contact information with outside
organizations except the UW Alumni Association.
Please check all that apply (make checks payable to "The UW-Madison Alumni Club of CT"):
__ I wish to join as a "friend" of the UW Madison Alumni Club of CT and Western MA."
A suggested annual $20 donation is enclosed.
__ I wish to contribute to the scholarship fund. My donation for $________ is enclosed.
__ I may be interested in planning or running club activities. Please contact me.
__ I may be interested in reviewing scholarship applications or organizing other activities
__ I may be interested in becoming a club officer. Please contact me.
Please provide suggestions for club events/activities and indicate your willingness to help organize or participate in new or existing activities. Suggestions on activity locations are also welcomed.
Questions? Feel free to contact club Secretary Jean Oliva at CTBadger83@aol.com or 860-298-6232.