National Association for the Advancement of Colored People

Savannah State University Chapter

MEMBERSHIP APPLICATION

 **CONFIDENTIAL**

Dues are $15.00 per semester

Please Type Neatly or Print

Name:    ______________________________________________________________________________

                Last                                                        First                                                       Middle

SSN:      _________________________________________            Date:      ________________________

School Address: __________________________________________________

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Home Address:    __________________________________________________

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School Phone:      __________________________________________________

Home Phone:        __________________________________________________

Other Phone:       __________________________________________________

Email Address:    ­__________________________________________________

Email Address:    __________________________________________________

Major:                    __________________________________________________