First Name:

Last Name:

Name enrolled under while attending WSCC:

Graduation Year:

Phone:

Program :

Home Address:

City:

State:     Zip:

Home Phone:

E-mail Address:

Employer or Bus. Name:

Work Phone:

   $15 

Student Membership – Current full-time or part-time students enrolled at WSCC.

  $25  

Regular Membership – Categories of membership are listed below.

$

Scholarship Donation (any amount is appreciated)

$

Total amount to be mailed

Type of membership

Graduate – Individuals who have graduated from a certificate or degree program at WSCC.

Regular – Former full-time or part-time students who did not receive a certificate or degree from WSCC.

Associate – Faculty, staff and friends of WSCC.

Make check payable to:
Wallace State College Alumni Association

Mail to:

Wallace State College
Cashier's Office
P.O. Box 2000
Hanceville, AL 35077-2000