Membership Dues Payment Form

Membership Definition: Any person who graduated from Camden Schools, or has been certified as an alternate diploma holder (e.g. GED, Military, etc.) is automatically a member of the Camden Alumni Association. To become an Active Member you need only pay annual dues. Active members, only, have the privilege of voting in Association elections.

Membership Year: The membership year commences at the Annual Meeting and Banquet, and expires at the next annual Meeting and Banquet.  Membership expiration is shown on mailings of the brochure and ballot in the address panel near your name.

Click Here to Download the PDF Version of the Membership & Scholarship Donation Form

 Title:    __ Mr.   __ Mrs.  __ Miss  __ Ms.   __ Dr.    __ Rev.  __ Sr.

First Name: _______________________________________     Middle Init.:______

Maiden Name: _____________________________________

Last Name:_______________________________________      Class Year:________

Street Address:_________________________________________________________

City:_________________________________    State:_________    Zip:____________

Home Phone:_____________________

Cell Phone: ______________________

Email Address:_________________________________

Dues paid for:
__ 1 Year ($5)
__ 2 Years ($10)
__ 3 Years ($15)
__ 4 Years ($20)
__ 5 Years ($25)
 __ Other:
___ Years @ $5/Year

Spouse’s Name: (If Camden Alumni, include Class Year, if female Alumni, include maiden name)

_____________________________________________________________________

Your birthdate: ______ / _____ / _________

Temporary Address: (If you have a temporary address, either for the Winter or Summer, please enter it below.)

Temp Street address: _______________________________________________

Temp City:__________________________     Temp State:______

Temp Zip:_____________

Temp Phone Number:________________________________________

Active Months:   Jan   Feb   Mar   Apr   May   Jun   Jul   Aug   Sept   Oct   Nov   Dec

Your parent’s name(s), if Camden Alums (include graduation year, also):

Name:___________________________________________________    Year: _________

Name:___________________________________________________    Year:_________

Current annual dues are $5.00 per year per person. Payment can be made for multiple years.  Send your dues payment to:

Camden Alumni Association
Lance Williams, Registrar
15 Selden Drive
Rome, NY 13440

If paying by  check, make payable to Camden Alumni Association.