Your Basic Information First Name: Last Name: Address: City: State: Zip Code: Class Year (four digits):

Phone Numbers & Email Home Phone: Work Phone: Cell Phone: Email:

Display On Site? Answer the following questions to decide if you'll be included on this website in our new membership directory.   Include my address and phone numbers in this directory: Yes No Allow people to contact me about my career field: Yes No All people to email me from this directory: Yes No NOTE: This websites will not display your email address. It will allow people to send you an email, and the system will then look up the email address. This helps protect you from spammers who write programs that automatically check websites for email addresses.

Optional Personal Information Add a Note About Yourself: Job Description: Job Type: CEO/Corporate ExecutiveClericalCommunications - Advertising/CreativeCommunications - JournalismCommunications - Marketing/Public RelationsConsultingEducationEngineeringFinanceFinance - Investment BankingFinance - TradingGraduate StudentHuman ResourcesInformation TechnologyInsuranceLawMedicineReal EstateTheaterTransportation Interests: Member Since:

Please Give Yourself a Password This password is for editing your membership profile or making future membership payments online. You will not need this to access the site. Password:

Membership Dues Alum $30 Parents $25 Family $40 Patron (includes 1 free event ticket) $100 Young Alum 1999 - 2009 $20 Scholarship Fund Contribution   During 1999-2000, the Dartmouth Club of Chicago raised $36,800 -- 3rd in Regional Club Scholarship funding. Total

Our preferred method of payment is PayPal.:



Click Here To Read About PayPal

Alternatively, you can print this form and mail it with a check to:

Dartmouth Club of Chicago P.O. Box 4671 Oak Brook, IL 60522-4671