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Roosevelt Golden Grads Membership Form
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Full Name/s (Including maiden name if applicable)
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Graduation Year/s
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Mailing address including city, state, zip
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Preferred phone number
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Email address
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Membership Category:
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$20: Individual Annual (valid through December 2022)
$30: Couple Annual- two individuals living in the same home (valid through December 2022)
$250: Individual Lifetime
$350: Couple Lifetime
Do you prefer your copy of The Grapevine:
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Please watch your email for a confirmation and a link to pay for your membership. Thank you! If you have any questions, please call us at 206.226.5679.
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