OKLAHOMA CORNHUSKER CLUB

Established in 1981

P.O. Box 470924 -  Tulsa, Oklahoma 74147-0924

www.infoman.net/occ

 

MEMBERSHIP APPLICATION

 

 

Name: _________________________________Spouse:        ________________________________

Hometown:______________________________ Hometown:    ________________________________

Mailing Address:_____________________________________________________________________

City, State, Zip:  ___________________________________________________________________

Phone:   ________________________________ FAX:  _____________________________________

Email: _____________________________________________________________________________

Employer:_______________________________  Spouse’s Employer:___________________________

Phone:_________________________________   Phone:_____________________________________

 

Are you a member of the Nebraska Alumni Association: Yes  ___   No  ___

 

Chapter affiliation     TULSA  ___    OKC  ____

 

Please check any of the following committees you would be interested in serving on:

 ___ Calling ___ Watch Party ___ Christmas Banquet ___ Publicity ___ Directory ___ Golf Tournament

 

ANNUAL MEMBERSHIP DUES  =  $20.00

 

Each year the club donates $1,000.00 to the Nebraska Scholarship Fund. Please give what you can to

help us continue with this and include it in your check made payable to:  Oklahoma Cornhusker Club.

 

   Membership Dues:  $20.00 + Scholarship Fund: __________   =   __________

 

 

Signature: _________________________________       Date: ________________