Alumni Association Membership Form

Date ______________ Year Graduated ______

Name ________________________________________________

Address _______________________________________________

City _______________________ State __ Zip _____

Phone ____________ Cell ___________ E-mail _____________________________

Dues are $15.00 per person and should be paid by December 31. Please make your check payable to:

CBS Alumni Assn.

Send to:

CBS Alumni Assn.

c/o Kalista Lehrer

3093 Lockport-Olcott Road

Newfane, NY 14108