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ALABAMA A&M UNIVERSITY ALUMNI ASSOCIATION, INCORPORATED MEMBERSHIP ROSTER COVER SHEET 2015 CHAPTER NAME: CHAPTER MAILING ADDRESS: CITY STATE ZIP TELEPHONE NUMBER ( ) TAX ID NUMBER Financial Secretary Treasurer Website FINANCIAL INFORMATION No. of Members Total ACTIVE MEMBER @ $50 $ LIFE MEMBERSHIP NEW LIFE MEMBERSHIP Maroon and White Member @ $500 $ Silver Member @ $1,000 $ Gold Member @ $5,000 $ ASSOCIATE MEMBER @ $20 $ CORPORATE MEMBERSHIP Maroon and White @ $300 $ Diamond @ $500 $ Executive Diamond @ $1,000 $ MEMBERSHIP TOTALS $ CHAPTER TAX ($25.00 minimum per year) CHARTER FEE ($50.00 new chapter fee) if applicable $ $ CONTRIBUTIONS: 1875 Normalite Campaign ($1000 minimum per chapter) $_ Legislative Reception ($250 minimum per chapter) $_ TOTAL THIS REPORT DEADLINE: FRIDAY, FEBRUARY 13TH

Page 2 Membership Roster Cover Sheet Please list the names of known deceased Normalites (January 2014-December 2014). Provide Dates / If Known 1. 2. 3. 4. Chapter President Signature

ALABAMA A&M UNIVERSITY ALUMNI ASSOCIATION, INCORPORATED CHAPTER ANNUAL REPORT 2015 NAME OF CHAPTER OFFICERS PRESIDENT VICE PRESIDENT

Page 2 CHAPTER ANNUAL REPORT RECORDING SECRETARY _ FINANCIAL SECRETARY _

Page 3 CHAPTER ANNUAL REPORT TREASURER _ PARLIAMENTARIAN _

Page 4 CHAPTER ANNUAL REPORT HIISTORIAN _ CHAPLAIN _

Page 5 CHAPTER ANNUAL REPORT PLEASE INDICATE NUMBER OF MEMBERS IN THE FOLLOWING CATEGORIES NEW MEMBERS _ LIFE MEMBERS ACTIVE ASSOCIATE HONORARY _ DAY/DATE/TIME AND LOCATION OF REGULAR MEETING(S) ENDOWED SCHOLARSHIPS TOTAL AMOUNT OF SCHOLARSHIP FUND NUMBER OF SCHOLARSHIPS AWARDED TOTAL AMOUNT AWARDED GENERAL SCHOLARSHIPS TOTAL AMOUNT OF SCHOLARSHIP FUND NUMBER OF SCHOLARSHIPS AWARDED TOTAL AMOUNT AWARDED CONTRIBUTIONS TO ALABAMA A&M UNIVERSITY (BE SPECIFIC) 1. 2. 3. 4. Does your chapter participate in the Council of Presidents Forum? YES NO

Page 6 CHAPTER ANNUAL REPORT CONTRIBUTIONS TO LOCAL COMMUNITY (BE SPECIFIC) 1. 2. 3. BANQUETS HELD 1. 2. 3. PICNICS HELD 1. 2. 3. OTHER EVENTS/ACTIVITIES 1. 2. 3. PROBLEMS/CONCERNS Report Submitted By: /Signature Office Date

OPTIONAL ALABAMA A&M UNIVERSITY ALUMNI ASSOCIATION, INCORPORATED CHAPTER FINANCIAL STATEMENT YEAR ENDING DECEMBER 31, 2014 of Chapter Submitted by: President Signature Treasurer_ Signature Date Approved by Chapter: Cash Balance: January 1, 2014 _ Cash Receipts for the Year: _ Membership Dues _ National _ Local _ Life Membership Maroon _ Silver _ Gold _ Income from Events _ Raffle _ Interest Income Other Receipts Total Receipts Cash Disbursements for the Year: General Operation Fund Cost of Fundraising Events Postage, Printing, and Supplies Normalite Legal Defense Fund Contribution to Alabama A&M University $ Chapter Tax (By-law change 9/04 - $ 25.00 minimum) Charter Fee ($50.00) $ 1875 Normalite Campaign (By-law change 9/04 -$ 1, 000.00 minimum) Legislative Reception (By-law change 9/04 - $ 250.00 minimum) $ Endowed Scholarship General Scholarship $ Other Costs Total Disbursements Cash Balance: December 31, 2014 Stocks, CD s, Other Holdings Total Assets

NATIONAL MEMBERSHIP ROSTER - 2015 Alabama Agricultural and Mechanical University Alumni Association, Incorporated Chapter LIFE MEMBERS Address City/State/Zip Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major

NATIONAL MEMBERSHIP ROSTER - 2015 Alabama Agricultural and Mechanical University Alumni Association, Incorporated Chapter ACTIVE MEMBERS ($50) Address _ City/State/Zip Home Phone Cell Phone Email Address Major Address _ City/State/Zip Home Phone Cell Phone Email Address Major Address _ City/State/Zip Home Phone Cell Phone Email Address Major Address _ City/State/Zip Home Phone Cell Phone Email Address Major Address _ City/State/Zip Home Phone Cell Phone Email Address Major Address _ City/State/Zip Home Phone Cell Phone Email Address Major Address _ City/State/Zip Home Phone Cell Phone Email Address Major

NATIONAL MEMBERSHIP ROSTER - 2015 Alabama Agricultural and Mechanical University Alumni Association, Incorporated Chapter ASSOCIATE MEMBERS ($20) Address City/State/Zip _ Email Address Address City/State/Zip _ Email Address Address City/State/Zip _ Email Address Address City/State/Zip _ Email Address Address City/State/Zip Email Address Address City/State/Zip _ Email Address Address City/State/Zip _ Email Address _

NATIONAL MEMBERSHIP ROSTER 2015 Alabama Agricultural and Mechanical University Alumni Association, Incorporated Chapter NEW MEMBERS Circle One Address _ Life City/State/Zip Home Phone Cell Phone Regular ($50) Email Address Associate ($20) Major Circle One Address _ City/State/Zip Life Home Phone Cell Phone Regular ($50) Email Address Major Associate ($20) Circle One Address _ City/State/Zip Life Home Phone Cell Phone Regular ($50) Email Address Major Associate ($20) Circle One Address _ City/State/Zip Life Home Phone Cell Phone Regular ($50) Email Address Major Associate ($20) Circle One Address _ City/State/Zip Life Home Phone Cell Phone Regular ($50) Email Address Major Associate ($20) Circle One Address _ City/State/Zip Life Home Phone Cell Phone Regular ($50) Email Address Major Associate ($20) Circle One Address _ Life City/State/Zip Home Phone Cell Phone Regular ($50) Email Address Major Associate ($20)

NATIONAL MEMBERSHIP ROSTER 2015 Alabama Agricultural and Mechanical University Alumni Association, Incorporated Chapter NEW LIFE MEMBERS Address City/State/Zip Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major Address City/State/Zip _ Email Address _ Major