Today's Date:
Prefix: Mr. Mrs. Ms. Your Full Name: Birth Date: Home Address: City: State and Zip Code: Home Telephone: Email Address: Please send mail to: Office Home
Title: Company: Business Address 1: Business Address 2: City: State and Zip Code: Telephone: Fax: Job Responsibilities: Geographical Focus: Previous Employers: Preferred First Name:
Office Retail Industrial Residential Hotel Land
Major and Mo./Year Awarded 1: Major and Mo./Year Awarded 2: Major and Mo./Year Awarded 3:
Institution: Degree/Awarded: Institution: Degree/Awarded:
Affiliate of Program Candidate for Degree (Mo./Yr)
Southern California Northern California Colorado/Texas Minnesota Western Wisconsin Eastern Wisconsin Illinois Northeast Southeast Pacific Northwest
Membership Categories (You must select one membership dues category to renew your membership.)
I wish to pay my 2007 membership dues by choosing the following level of support. (Note: Your payment covers national and regional dues, and is tax deductible to the extent permitted by law.)
*Special Note: Alumni and Affiliates who choose to provide a special level of financial support under the Cornerstone or Sustaining Membership dues level, will be recognized for their commitment in the Annual Report.
Method of Payment: Check AMEX MasterCard Visa (We do not accept any other credit cards.)
Credit Card Number** _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date (Mo./Yr.) _ _ /_ _ Amount $_______________
Card Billing Address: __________________________________________ Card Billing Zip Code: ______________
Signature: __________________________________________________________________________________
**DO NOT SUBMIT CREDIT CARD INFORMATION ONLINE!
If you have had a change in information, please complete this form and return it with your dues payment. You may submit this form online, or you may print out this form, and send it through regular mail with your payment. Please make check payable to "WREAA," and mail payment to: Wisconsin Real Estate Alumni Association, Inc., P.O. Box 307, Pewaukee, WI 53072.
WREAA will also accept AMEX, Visa, or MasterCard payments for dues if mailed or faxed (262-746-9031) with appropriate billing information (billing address/zip code and expiration date).
Thank you for your continued support of the Wisconsin Tradition in Real Estate Education!
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