Dues Form

All retired members of the faculty of California State University, Los Angeles who have been awarded emeritus status are invited to join the Emeriti Association. If you wish to join, please print this page, complete the requested information, and MAIL the form with your CHECK, payable to CSU Los Angeles Emeriti Association, to:

Treasurer, Emeriti Association
c/o President's Office, Adm 815
California State University, Los Angeles
5151 State University Dr.
Los Angeles, CA 90032

Please note, the membership year is June 1 - May 31.



Name _________________________________________

Address _______________________________________

City _______________________________ State ______ ZIP ____________

Telephone (_____) ________________(Country Code if outside US ______)

E-mail __________________________________

CATEGORY (Please check)

_____ Contributing Life Membership $300

_____ Life Membership $200

_____ Supporting (Annual) Membership $25

_____ Regular (Annual) Membership $15

_____ Associate (Spouse, Annual) Membership $7.50