The Rutgers Club of New York City

Please mail this form and a check to:

The Rutgers Club of NYC
C/o Michael Shenberg, White & Case, LLP, 1155 Avenue of the Americas, New York, NY 10036-2787.

The Rutgers Club of New York City
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Membership Registration / Event Registration (Mail in) Printer-Friendly Form

Event (please indicate events you are registering for)	Number of Tickets/People	Cost
1. ________________________________________	______	$________
2. ________________________________________	______	$________
3. ________________________________________	______	$________

Total: $________

Personal and Mailing Information:

Name:	_________________________________________
College:	___________________	Class:	_______________
Home Address:	_________________________________________
Home Phone:	__________________	Fax:	________________
Undergraduate Major:	_________________________________________
Graduate Education:	_________________________________________
Current Job Title/Field of Work:	_________________________________________
Business Address:	_________________________________________
Business Phone:	___________________	Fax:	_______________
Business Email Address:	_________________________________________
Extracurricular Activity (1):	_________________________________________
Extracurricular Activity (2):	_________________________________________

Don't Forget to Include the Check!

Thanks for Registering
- Rutgers Club of NYC

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