Washburn Rural High School Alumni Association Membership Application
Name ________________________________________ Class of ___________
First M.I. Last Maiden
Address __________________________________________________________ Street
__________________________________________________________
City State Zip
Email ______________________________________________________
Home Phone ________________________________________________
Place of Employment ___________________________________________________________
Spouse’s Name ________________________________________ Class of ___________
First M.I. Last Maiden
____ I am interested in volunteering for __________________________________________________________
How did you learn about the Washburn Rural Alumni Association
__________________________________________________________
Please check type of membership (please check one option from each line):
_____ alumni _____ faculty _____ friend
____ Single Membership ($10 per year) ____ Couple Membership ($15 per
year) ____ Lifetime Membership ($200 per member)
Please
make checks payable to the Washburn Rural High
School Alumni Association and mail to Karen
Eastman, Treasurer, 1217 SW Fillmore, Topeka,
KS 66604. In addition, a tax deductible contribution can also be made payable to the Auburn-Washburn Foundation for specific alumni association use by indicating the WRHS Alumni
Association on the memo portion of your check.
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