La Porte High School Alumni Association
Membership Form

Name: 
                       Last Name                        First Name                      Middle

Maiden Name:         Sex:    F    M

Spouse Name: 

Year Graduated: 

Address: 

City:          State:          Zip: 

Home Phone:          Work Phone: 

Occupation: 

Type of Membership Desired

Regular Membership  ($10 per year - each membership)                       

Associate Membership  ($10 per year - each membership)                     

Life Membership  ($100)                                                                                  

Life Associate Membership  ($100)                                                                

Memorial Gift:                        
                                          Last                        First                        Middle                  Year

Donation to Alumni Scholarship / Grant Fund:                                            

Total Amount of Check Enclosed:                                                                 

Please make check payable to LPEF/Alumni Association and mail with this printed application to:
LPHS Alumni Association
P.O. Box 1878
La Porte, TX  77572-1878

Regular Membership:  Any ex-student of La Porte High School upon payment of dues shall be classified as a                                       Regular Member.

Associate Membership:  Any person, entity, or organization that demonstrates evidence of genuine interest in the                                       welfare of LPISD, upon payment of dues, shall be classified as an Associate Member.