Alumni Association Use Only :

Alumni Association Membership Number____________________________

Date Recieved _______________________________________________________

(Do Not Separate)                        

_________________

Initial Last Name

Eli Whitney Tech/ Boardman Trade

Alumni Association Registration Card

(Please Print Legible)

Name ___________________ Initial_____Last ______________________ (Jr. / Sr.) D.O.B__________

Maiden Name ____________________ Name in Yearbook (If Different)__________________________

Address ______________________________ Apt.____ City___________________ State___ Zip _______

Email____________________________ Cell_____________________ Tel No.______________________

If a Student: Yr._______ Name of College/School___________________ Course study________________

Address ______________________________ Apt.____ City___________________ State___ Zip _______

Circle One: Boardman Trade/ Eli Whitney Tech. HS GraduationYear _____ Shop________________

Current Occupation ______________________________ Retired __________ Years__________________

Employer/Self _______________________________________ Telephone__________________________

Address ______________________________ Apt.____ City___________________ State___ Zip _______

Please Contact Me For:

Reunions   _____                                                   Social Events  _____      

Sponsorships                                                          Fundraisers    _____       

THIS INFORMATION IS CONFIDENTIAL, AND FOR USE BY THE ALUMNI ASSOCIATION ONLY.

Please notify the Alumni Association of any changes to the Current Information.

Dues for the membership in the Alumni Association is $20.00 for 5 years, please send

MONEYORDERS, CHECKS or BANKCASHIER CHECKS: DO NOT SEND CASH

Cut Out Entire Form and Send To:

Eli Whitney Alumni Association

PO Box 9022

New Haven, CT

06532