Southern Nash High School
6446 Southern Nash High School Road
Bailey, NC 27807
School - 252-451-8520 Fax
– 252-478-5953
Title
(Mr, Ms, Dr)
First Name Last Name
Membership Year: January 2015 – July 31, 2016
Street Address
City
Email Address
State
Phone Number
Last Name during High School
(if different)
Zip Code
Graduation Year
(Please check the corresponding box)
$10
Newsletter, Recognition, Alumni Decal
(For Alumni who have been out of school 4 years or less)
(Current, Former, Retired)
$25 Newsletter, Recognition, Alumni Decal
$50 Newsletter, Recognition, Alumni Decal
$250
Newsletter, Recognition, Alumni Decal, One (1) All-Access Pass to school events
$500
Newsletter, Recognition, Alumni Decal, Recognition at Homecoming Football
Game, Two (2) All-Access Passes to school events
$1000
$2500
Newsletter, Recognition, Alumni Decal, Recognition at Homecoming Football
Game, Recognition during Alumni Night during Basketball Season,
Four (4) All-Access Passes to school events
Newsletter, Recognition, Alumni Decal, Recognition at Homecoming Football
Game, Recognition during Alumni Night during Basketball Season,
Six (6) All-Access Passes to school events
Forty percent (40%) of your membership will be allocated to the Alumni Association Scholarship fund. If you wish for the remaining percentage to be appropriated to specific areas within the school, please indicate by writing the percentages next to those areas (not to exceed 60%).
Please make check payable to:
Southern Nash High School PTO/Alumni Association
Academics
40% Alumni Association Scholarship
Athletic Program
Band Program
Chorus Program
FFA Program
Media Center
PBIS (Positive Behavior Support)
PTO (Parent/Teacher Organization)
Other:
Please specify
Tax receipt will be mailed to donor address listed above.
Thank you for your membership to
Southern Nash High School Alumni Association. t n
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