Your participation in the Yale Club of Chicago makes it possible to schedule more events for a broader range of members. Simply print this page and fill out the form below.
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Name: _________________________________________ Yale Degree(s)/Year(s): ____________________

Fill in the following if spouse is also a Yale graduate:

Spouse's Name: __________________________________ Yale Degree(s)/Year(s): ____________________

Preferred Mailing Address: _____________________________________________________________________

City: ______________________________________________ State: __________ Zip: ______________

Preferred Email Address: ________________________

Home Phone: ________________________

Home Fax: ________________________

Work Phone: ________________________

Work Fax: ________________________

Alternate Email Address: _______________________

Consider signing up for the Virtual Yale Station so you can have a permanent Yale email address that will forward to your preferred email address. Go to http://www.aya.yale.edu/vys.

___Please contact me about tutoring at Elihu Yale Elementary School

___I am interested in helping Yale initiate a relationship with a local high school

___I am willing to help with event planning and/or web site development for the Club

___I would like to help with alumni interviewing for Yale

___I prefer to be contacted about Club events via U.S. mail rather than e-mail

ANNUAL DUES SCHEDULE: Please check the appropriate category.

Note: Joint membership is available in all membership categories at no additional charge to couples when both individuals are an alumnus/alumna of Yale University. To qualify, simply fill in your spouse's degree information above.
_____ Patron $200          _____ Basic $80         _____ Complimentary for Class of '07
_____ Special $30 (check one of the following categories):
            _____Classes of '02-'06       _____ Non-resident (live and work > 50 miles from Chicago)
            _____ Parent (parents of any Yale students or alumnus/a)

Enclosed is my check for $____________, made payable to the Yale Club of Chicago.

Please charge $_____________ on my ____VISA or ____Mastercard

Card number___________________________________ Exp. date__________

Signature_______________________________________________________

Please mail your check and/or this form to the Yale Club of Chicago, P.O. Box 350, Kenilworth, IL 60043-0350