Dental Alumni News - University of Washington School of Dentistry
Dental Alumni News - University of Washington School of Dentistry
Dental Alumni News - University of Washington School of Dentistry
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Membership Matters!<br />
Have you renewed your 2003 membership in the <strong>Dental</strong> <strong>Alumni</strong> Association?<br />
For your convenience, we now accept credit card payments!<br />
$60.00 Annual Membership Dues to be paid by:<br />
Check made out to the <strong>Dental</strong> <strong>Alumni</strong> Association<br />
(U.S. Funds only, please)<br />
MasterCard or Visa<br />
ACCOUNT NUMBER EXP. DATE<br />
NAME ON CARD<br />
SIGNATURE<br />
ADDRESS SERVICE REQUESTED<br />
<strong>University</strong> <strong>of</strong> <strong>Washington</strong><br />
Office <strong>of</strong> Development–<strong>Alumni</strong> Services<br />
<strong>School</strong> <strong>of</strong> <strong>Dentistry</strong><br />
B471 Health Sciences Center<br />
Box 357137<br />
Seattle, WA 98195-7137<br />
Please identify type <strong>of</strong> membership:<br />
Regular Member (UW DDS/MSD/Cert. Grad.)<br />
Associate Member (Non-UW <strong>Dentistry</strong> Alum.)<br />
NAME<br />
ADDRESS<br />
CITY STATE ZIP<br />
Please send this form with payment to: UW <strong>Dental</strong> <strong>Alumni</strong> Association, Box 357137, Seattle, WA 98195-7137<br />
Or fax to: (206) 543-6465<br />
PHONE<br />
Non-Pr<strong>of</strong>it Org.<br />
U.S. Postage<br />
P A I D<br />
Seattle, WA<br />
Permit No. 62
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