Kentucky State Alumni Cleveland Chapter
On-line Member Add Request
Please use this page only to ADD A MEMBER not currently on file
For Use Only by Person(s) Authorized to Update the KSU Cleveland Alumni Database
Fax Number:
NEW INFORMATION BELOW
Please fill in as completely as possible
First Name
Middle Initial/ Name:
Home Phone Number:
E-mail Address:
Last Name:
Salutation:
(Mr., Ms., Mrs., Dr., etc.)
Street or P.O. Box:
City:
State:
Zip Code:
Business Phone Number:
Beeper Number:
Cell Phone Number:
Membership Type:
Administrator's E-mail Address:
Cleveland, Ohio
Alumni Chapter