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.)

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 ______________________________   City_____________________ State_____ Zip _________

Circle One: Boardman Trade/ Eli Whitney Tech.HS GraduationYear ______ Shop_________________

Current Occupation ____________________________ Retired _____________ Years________________

Employer/Self _________________________________________ Telephone_______________________

Address ______________________________   City_____________________ State_____ Zip _________

Please Contact Me For Reunions, Social Events, Sponsorships and Fundraisers.  Yes / No

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