DWCUAA - Membership Registration

Divine Word College of Urdaneta Alumni Association

DWCUAA - Membership Registration

If you are interested in joining the group, please fill out the following form. The information provided will be kept confidential and will be used primarily to inform membership of current events.

Annual membership fee: $10.00 per alumni

Lifetime membership fee: $100.00 per alumni

Please make check/money order payable to:

DWCUAA

c/o Lorna Sarmiento-Gemino

438 Navito Way

Oxnard, CA 93030

Date of Registration:
Full Name (including Maiden):
Home Address:
E-Mail Address:
Year Graduated/Attended:
Did you attend the High School?
Or, did you attend the college?
Type of Membership:
Amount Paid:
Land line No.:
Fax No.:
Cell No.:
Birthday:
Do you wish us to contact you of future events?
Best way to contact you:

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