The Roosevelt-Wilson/Washington Irving/ Kelly Miller & Robert C. Byrd Alumni & Friends Foundation,Inc.
One Eagle Way
Clarksburg, WV 26301
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MEMBERSHIP INFO:
Please return your membership fee to the
The R-W/WI/KM & RCB Alumni & Friends, Inc.
c/o Deborah Frum
One Eagle Way
Clarksburg, WV 26301         ______ New    ______ Renewal
Name:____________________________________
School:_________________________
Membership Category _____ Lifetime _____ Regular
Graduate (Class of_____)
Contributor's Mailing Address____________________________________________
 
1.) Foundation Membership Regular 
Jan. 1 - Dec. 31
$15.00
Lifetime Membership $200.00
   
2.) Special Contribution to the 
Foundation (optional) 
$500.00 A scholarship & Lifetime Membership
$______
   
Total Contributions to the Foundation (add lines 1 & 2)
$________
   


Tax deductible contributions should be made by check or money order and made payable to The Roosevelt-Wilson/Washington Irving Alumni & Friends Foundation, Inc. and mailed with this form to: 
The Roosevelt-Wilson/Washington Irving Alumni & Friends Foundation, Inc. 
One Eagle Way
Clarksburg, WV 26301

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