UVI Alumni Association - Registration Form


	CREDIT CARD AUTHORIZATION

Appeal/Events:

Credit Card # ________________________ Expiration Date: ________________

VISA ______ MASTERCARD _____ AMEX _____ CID # ____
(Note: AMEX cardholders places include 4-digit CID Number on right side of card.)

By signing below, I assume full responsibility for this credit card transaction.

For ________________________________ in the amount of $ ____________________.
Alumni/Friend Name

____________________________________ ______________________________
Print Name of Card Holder Date

_____________________________________
Signature of Card Holder

Mailing Address: _________________________________________________________

_______________________________________________________________________

Telephone: Work _____________________ Home ________________________

Mail completed form to:

University of the Virgin Islands
Alumni Affairs Office
2 John Brewer's Bay
St. Thomas, VI 00802-9990