Sponsor a Student for FACUL

I am interested in sponsoring_____student(s) as members of FACUL for one year.

Student's name(s)____________________________________________________

_________________________________________________________________

-or-

Please select the student(s) for me from the following list:

Library Student Worker(s)

Student(s) in Honors Program

International Student(s)

Other___________________
Quantity

_______

_______

_______

_______

My check in enclosed for $37.50 per student for membership(s) and ticket(s) to the FACUL Lectureship Dinner.
Please charge my (circle one:) Visa Mastercard Discover American Express

Name as it appears on card:_____________________________________

Card #:________________________________Exp. Date:_____________

Amount:____________Signature:_________________________________

Please complete for our records:

Name_______________________________________Phone________________

Address__________________________________________________________

City_________________________________State_______Zip_______________

email____________________________________________________________