Class Dues Form

The Great Class of 1965

Class Dues Form

You may use the form below to pay your Class dues if you have not already done so. The dues year runs from July 1 to June 30 and two notices have previously been sent by mail. $20.00 of the dues amount will be placed in the Class of 1965 Scholarship Fund, but we encourage you to consider donating an additional amount to the Scholarship Fund, as many Classmates have been doing.

To pay your dues, print out this form, fill in your name, and send it to the address noted on the payment portion. Thank you for participating.

Your Class Dues covers your subscription to the Dartmouth Alumni Magazine,

Class mailings and other Class activities.

Please tear off bottom portion and return with your payment or donation.

Make your check payable to: Class of 1965

Your Name ________________________

Address ________________________

________________________

Class dues for the year 2002 / 2003 $60.00

1965 Scholarship Fund ______

Total =====

Please return with your check to:

DARTMOUTH 1965

Stephens Fowler, Treasurer

6068 Blunt Alumni Center, Rm. 309

Hanover, NH 03755-3590

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