Application for Membership

Having attended and/or graduated from the University of California at Berkeley,

I,____________________________ hereby apply for membership in the Northern C's Alumni Club.

I attended Berkeley from _________________ to _________________.

My undergraduate major was _________________________________.

Name: _____________________________

Address: ___________________________

City: ______________________________ State: ______ Zip: _______________

E-Mail Address: ______________________________

Home Phone: _________________________________

Business Phone: _______________________________

Date: _______________________________________

I am a member of the California Alumni Association:   YES ______  NO ______

Please Print this form, complete and mail with a $15.00check to:

Ron Bresolin, Treasurer
926 River Bend Rd.
Redding, CA 96003-3731