Alumni

______ $25.00 Individual

______ $40.00 Couple

______ $250.00 Lifetime

Please print and mail this form to: Co-Lin Alumni Association
P. O. Box 649
Wesson, MS 39191

NAME ________________________________________PHONE _________________

ADDRESS:________________________________E-MAIL ______________________

CITY: ____________________________________ STATE _____ ZIP __________

YEARS OF ATTENDANCE_________________YEAR GRADUATED ____________

Thank you for your support of Copiah-Lincoln Community College.