Why join the West Point Society of Silicon Valley?

Join Today! Member Application and Data Form

The following information is for our mailing list and for our annual roster. If there is information you do not want in the roster, just indicate by enclosing in parentheses, i.e. (Graduated Harvard Law School):

Please print this form and send it to the below address or use our online membership by clicking the link below.

Click here for Online Membership

First ____________________ Middle ____ Last ____________________ Suffix ____

Salutation: ___________________ Nickname: _______________________________

Organization: _______________________ Business Title: ______________________

Work Address: _______________________ Work Phone: _____________________

City ___________________________ State ______ Zip Code __________________

Home Address: ______________________ Home Phone: ______________________

City ____________________________ State ______ Zip Code __________________

Military Rank: _____________________ USMA Class: ____________

Email Address: _______________________________________________

Mail Preference? Home or Office (circle one)

Spouse Name: ______________________ Spouse a Grad? If so, Class Year:_______

PARTICIPATION INTEREST:

I would like to serve:

as a Board Member: ____		on a Career Advisory Committee: ____
on an Activity Committee: ____		as a Speaker Coordinator: ____
as a Class Point of Contact: ____		on a Founders Day Committee: ____
in another capacity (describe): __________________

PAYMENT:

Please make your dues (and any contributions) payable by check to the West Point Society of Silicon Valley (WPSSV). All dues-paying members will receive the 2004 Membership Roster to be published in April 2004. Contributions are not tax deductible.