2015/2016 Season
Membership Application
The Ohio State Alumni Club of Central Florida is a self-supporting group of Ohio State Alumni and Supporters who strive to
promote The Ohio State University through a wide range of activities. The Club is affiliated with The Ohio State University Alumni
Association, Inc. Membership in the Club does not include membership in the Alumni Association nor does membership in the
Alumni Association include membership in the Club. Attendance at Ohio State is not required to join the Club.
Please Print and complete form:
Name: __________________________________, __________________________
Spouse: __________________________
Last
First
(Family Membership)
Address: _________________________________________________________________________________________________
Street
City
State Zip Code
Email: _________________________________________________
Contact Phone: ___________________________________
E-mail needed to get club email
Occupation (optional): ____________________________________
Are you an Ohio State University Alumnus?
YES
Work Phone: _____________________________________

NO
If YES, what years did you attend OSU? _____________________________
Degree: _________________________________
Are you a member of The Ohio State University Alumni Association, Inc.? If yes enter#________________________________
___________________________________________________________________________________________________________
The success of our club is based on the participation of its members. If you would like to be more involved in our club, please
circle the following area(s) you would be interested in:
Sell 50/50 Tickets
Activities
Spirit & Recognition
Fund Raising & Gifts
Take Pictures for Website
Working Welcome Table on Game Day
Make Buckeye Candy for Game Day
Date: ___/___/___
Donation to Scholarship Fund:
Scholarship
$_________
Dues (Individual $15.00, Family $25.00) remitted with application: $_________
CASH CHECK#___________ $__________
Make checks payable to: Ohio State Alumni Club of Central Florida
Mail check and form to: Ohio State Alumni Club of Central Florida
C/o Treasurer & Membership Chairperson
P.O. Box 941707
Maitland, Fl. 32794-1707
Please visit our website: www.centralfloridabuckeyes.com
When using Paypal add $1.00
Revised: 05/23/2015