BAN Membership Registration

Hello Alumni,

Please complete the BAN Membership form below.
Click the ‘Register Now’ button in order to complete your registration.

The annual membership fee is twenty-five dollars ($25).
You have two (2) options in order to pay for your dues.
1) Use PayPal by clicking on the PayPal image.
2) Send a personal check to the address listed below.

Make your checks payable to and mail to:
UNT Black Alumni Network
P O Box 222037
Dallas, TX 75222

Thank you so much for your interest in becoming a member of UNT-BAN.
We look forward to your participation in making us better.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Alumnus First Name *

Alumnus Last Name *

Address 1 *

Address 2

City *

Zip / Post Code *

Phone

Email *

Method of Payment for Annual Dues (PayPal or Check) *

PayPal
Personal Check

Years Attended UNT

Member of UNT organizations

Field of Study

Degree Received

Are you a business owner?

If checked, Business Name and Address

Would you be willing to support on-the-job training for African American students through an internship?

Briefly describe product/service that your business provides

Would you be willing to be a mentor to an African American student at UNT?

If checked, in what field of study

Are you a member of the UNT Alumni Association (UNTAA)? Note:This is not required to be a member of BAN.

If checked, please provide your UNTAA membership number. Contact UNT alumni association at alumni@unt.edu or 940-565-2834 for replacement card.

Would you be interested in working on the 2016 Homecoming Committee?

Additional Comments

Please click on the image below to access UNTBAN PayPal to pay membership dues

BAN Membership Registration

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