CCS Foundation

Welcome!

You've made a great decision. You're one step away from joining the CCS Alumni Association. Complete this form and click submit to join.

*Indicates required fields. Please be aware that unless all required elements are completed, your form will not be submitted.

Full Name (First, MI, Last)*:

Name while attending CCS:

Nickname:

Gender:

Student ID Number (If known):

Birthdate (MM/DD/YY)*:

Address*:

City*:

State*:

Zip*:

Phone Number:

() -Second partThird part

E-Mail Address*:

Date graduated or last attended*:

Program/Major*:

Degree(s) earned (i.e. Cert, AAS, AA):

Please select your campus*:

Employer:

Occupation:

Sport (if any) played for CCS?:

Did you receive a CCS foundation scholarship?:

If so, please name scholarship(s).:

How did you hear about the CCS Alumni Association?:

Other, please explain:

Spouse's Full Name:

Student ID Number (If Known):

Birthdate (MM/DD/YY):

Spouse's Phone:
() -Second partThird part

Spouse's E-Mail:

Did he/she attend CCS:

Spouse's Name While Attending:

What year did he/she last attend:

Which campus did he/she attend:

Program/Major:

Degree(s) earned (Cert, AAS, AA):

Comments/Other Information you would like to tell us about:

If you would prefer to fax or mail your membership application, please click here to download the CCS Alumni Association membership application and fax it to (509)434-5135 or mail to the address below.

Full Name (First, MI, Last)*:
Name while attending CCS:
Nickname:
Gender:
Student ID Number (If known):
Birthdate (MM/DD/YY)*:
Address*:
City*:
State*:					Zip*:
Phone Number:					() -Second partThird part
E-Mail Address*:
Date graduated or last attended*:
Program/Major*:
Degree(s) earned (i.e. Cert, AAS, AA):
Please select your campus*:
Employer:
Occupation:
Sport (if any) played for CCS?:
Did you receive a CCS foundation scholarship?:
If so, please name scholarship(s).:
How did you hear about the CCS Alumni Association?:
Other, please explain:

Spouse's Full Name:
Student ID Number (If Known):
Birthdate (MM/DD/YY):
Spouse's Phone:					() -Second partThird part
Spouse's E-Mail:
Did he/she attend CCS:
Spouse's Name While Attending:
What year did he/she last attend:
Which campus did he/she attend:
Program/Major:
Degree(s) earned (Cert, AAS, AA):

Comments/Other Information you would like to tell us about:

CCS Foundation

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