Delaware Chapter
West Virginia University
Alumni Association

Membership Form
Delaware Chapter
WVU Alumni Association

How to complete this form:

• Print page using the FILE/PRINT option on your browser 
• Fill out the printed page
• Enclose membership dues check 
• Mail to Drew Shears

NAME: 

SPOUSE (if app)  

ADDRESS 

E-MAIL ADDRESS   

PHONE 

MEMBERSHIP LEVEL (circle one) (LIFE) (5 YEAR) (1 YEAR)

1 Year $15.00 5 Years $35.00 Life $95.00 License Plate $50.00

Make checks payable to:
State of Delaware Chapter, WVU Alumni Association

Mail to:

Andrew Shears
12 Highland Circle
Newark, DE 19713