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›› Renew online at www.TexasTechAlumni.org or by phone at 806.742.3641

MEMBERSHIP FORM

Please fill out, print and return form to: TTAA, P.O. Box 45001, Lubbock, Texas 79409-5001
NOTE: to print go to "file/print", under the "print frames" option check "only the selected frame"

Name Class Year

Spouse�s Name Class Year
My spouse joins me in making this gift.   My spouse is a Texas Tech alumnus.

Address

City State Zip

Home Phone Work Phone

Social Security No. E-mail

Spouse�s Social Security No. Spouse�s E-mail

Platinum ($2,500 or more annually)

1   2   3 years = $
Gold ($1,000 to $2,499 annually) 1   2   3 years = $
Silver ($500 to $999 annually) 1   2   3 years = $
Bronze ($250 to $499 annually) 1   2   3 years = $
Century ($100 to $249 annually)1   2   3 years = $
Loyalty ($35 to $99 annually) 1   2   3 years = $

Enclosed is my check for $ (Please make checks payable to TTAA.)
I�ve included my company�s matching gift form
Please send me a bank draft authorization form (Century level and above)
Hassle-Free Option: Automatically renew my TTAA membership by charging my credit card annually.
       (Century level and above)
Charge my:   Exp. Date
Name on Card Account Number

Cardholder Signature_____________________________________________________________________________