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Become a Member : Printable Membership Form

To join STAT, fill out and print this form and mail it along with your check to:

STAT
C/O SIUE Alumni Association
Campus Box 1031
Edwardsville, IL 62026-1031

You may also stop by the office on the first floor of Birger Hall to drop off your application.

Printable Membership Form

1. Your Information
Last Name
First Name
Banner ID #
Maiden Name
Title Select title
Mr. Mrs. Ms. Miss. Dr.
Current Grade Level
Fresh Soph Junior Senior Grad
Expected Graduation Date
Major(s)
Previous SIUE Degree(s) and Graduate Date(s) (if applicable)
E-mail
T-Shirt Size
S M L XL XXL
3. Spouse Information
Yes! My spouse/domestic partner is current student.
Yes! My spouse/domestic partner is an alumna/us.
Last Name
First Name
Middle Name
Maiden Name
Title Select title
Mr. Mrs. Ms. Miss. Dr.
SIUE Current Grade Level
Banner ID #
SIUE Graduation Year(s)
SIUE Degree(s)
E-mail
4. Mailing Information
Address
City
State
Zip Code
Home Telephone