Name: Madien Name:
Address:
Phone Number: email:
School Attended: Year graduated:
$10 annual membership $100 lifetime membership
Please print out form and submitt along with check for membership.
Make checks payable to:
Binghamton Alumni Association
and mail to
Binghamton City School District
c/o Chris Rozek, Membership Secretary
98 Oak Street
Binghamton, NY 13905