* = required fields

First Name*
Middle Name*
Last Name*	Preferred Name
Email*
Male Female	Class Year*
	freshman sophomore junior senior graduate student
Birthday mm/dd/yy
Last 4 digits of SSN*
Banner ID#
Auburn Street Address
City
State
Zip
Phone
Cell Phone
Parents'/Guardians Names'
Did your parent/s graduate from Auburn?
Father-YES Father-NO Mother-YES Mother-NO
Permanent Street Address
City
State
Zip
Phone

MEMBERSHIP PAYMENT OPTION*

Annual Membership fee is $20 per year (August 1, 2010 - July 31, 2011) Four-Year Membership fee is $70 (August 1, 2010 - July 31, 2013)

(Freshman only, does not extend to Auburn Alumni Association Membership)