West Point Parent Club St Louis Area Membership Form

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Parent Information

            Name                                       ------------------------------------------------

            Address                                   ------------------------------------------------

            City, State Zip                          ------------------------------------------------

            Phone Number                         ------------------------------------------------

            Email (important)                     ------------------------------------------------

            Congressional District              ------------------------------------------------

 

Cadet/Graduate Information

Grad Rank                               ------------------------------------------------

            Name                                       ------------------------------------------------

            Company & Regiment or         ------------------------------------------------

            Grad Division/Battalion           ------------------------------------------------

Address or Box Number          ------------------------------------------------

City, State, Zip                         ------------------------------------------------

Birth Day                                 ------------------------------------------------

            Class year                                ------------------------------------------------

            Email                                       ------------------------------------------------

 

Membership Dues                                ------------------------------------------------

            ($35 for Cadet Parent)

            ($20 for Graduate Parent)

WPPC Name Badge (New Parents)      ------------------------------------------------

            ($5 each includes shipping)

 

Total Enclosed                                     ------------------------------------------------

 

Check Due by                                      September 1, 2007

 

Please make checks payable to            West Point Parents Club

Call to return form and check to:         Michael & Nancy Alderson

                                                            ald7611@swbell.net

314-725-7071