Prospective Member Interest Form Contact Information NAME: _____________________________________ SPOUSE: ___________________________________ COMPANY: __________________________________ MAILING ADDRESS: ________________________________________ _________________________________________________________ OFFICE PHONE: ( )_______________________________________ FAX: ( )_________________________________________________ E-MAIL ADDRESS: _________________________________________ Membership Status _______ Yes, I would like to support programs in the College of Agriculture and Life Sciences at Texas A&M University by joining the COADC! 1. _____ Individual ($1,000) _____ Corporate ($2,000) allows for 2 representatives 2. _____ A check for 2008 dues is enclosed _____ Please bill me *** Please make check payable to: Texas A&M Foundation - COADC *** _______ I would like to think about it–please keep me on the mailing list. _______ No, I do not wish to join–please remove me from the mailing list. Please return this form to: College of Agriculture Development Council Attn: Danielle Galow Suite 113 Jack K. Williams Administration Building College Station, Texas 77843-2142 Fax: 979/845-9938 E-mail: dgalow@tamu.edu Updated 05/06/08
Prospective Member Interest Form
Contact Information
NAME: _____________________________________
SPOUSE: ___________________________________
COMPANY: __________________________________
MAILING ADDRESS: ________________________________________
_________________________________________________________ OFFICE PHONE: ( )_______________________________________ FAX: ( )_________________________________________________ E-MAIL ADDRESS: _________________________________________
Membership Status
_______ Yes, I would like to support programs in the College of Agriculture and Life Sciences at Texas A&M University by joining the COADC! 1. _____ Individual ($1,000) _____ Corporate ($2,000) allows for 2 representatives
2. _____ A check for 2008 dues is enclosed _____ Please bill me
*** Please make check payable to: Texas A&M Foundation - COADC *** _______ I would like to think about it–please keep me on the mailing list.
_______ No, I do not wish to join–please remove me from the mailing list.
Please return this form to: College of Agriculture Development Council Attn: Danielle Galow Suite 113 Jack K. Williams Administration Building College Station, Texas 77843-2142 Fax: 979/845-9938 E-mail: dgalow@tamu.edu
Updated 05/06/08
