INVOICE

Name:  ______________________________________________________

Email Address:  ____________________________________________________

Birthday (Month/Year):  ____________________________________________________

School/Chapter: _____________________________________ Grad. Year: ______

___ Please add me to the NYC Metro Email news and information list

I support the Alpha Phi Alum Chapter! Enclosed are my chapter dues for August 1, 2008, - July 31, 2009:

____	Ursa Minor - $30 (Recent Grads - 5 Years and Under)
____	Ursa Major - $40
____	Silver & Bordeaux Member - $50 and over

Checks are payable to: NYC Metro Alumnae Chapter of Alpha Phi
(No cash accepted. Credit card payments may be made through our PayPal account.)
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Please complete this form and e-mail Jessica Weinberg to obtain the mailing address for your check.