CAA Membership Form

Cyclones Athletic Association

Membership Form

________________________________ Make Check Payable To: UW-Fox Valley

Name

______________________________________

Address My membership is:

______________________________________ ______ New ($50.00)

Phone

______ Renewal ($50.00)

______________________________________

City, State, & Zip

Please use my contribution towards:

______________________________________

Name of Business ______ Athletic Department

______________________________________ ______Women’s Volleyball

Occupation/Title

______ Women’s Basketball

______________________________________

Business Address ______ Men’s Basketball

______________________________________ ______ Soccer

Phone

______ Tennis

______________________________________

Specify Name to Appear in Program ______ Golf

______________________________________

Preferred E-mail address

Polo Shirt Size:

_____ Small _____ Large _____ XXL

_____ Medium _____ X Large

***The cost of goods received is $20.00 which is not tax deductible***

If you would like to become a member of the Cyclones Athletic Association, please complete this form and mail it with your contribution to:

UW-Fox Valley

Attn: Cyclones Athletic Association

1478 Midway Rd.

Menasha, WI 54952