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Board of Fellows Application

Membership Proposal and Application
~ All applications must be reviewed and approved by the Board of Fellows Membership and Steering Committees ~
The Board of Fellows Annual Financial Commitment is $1,250.
($250 membership dues and a minimum of $1,000 towards UT’s Annual Fund)

* Denotes required field.  

*Applicant's Name:

Prefix:


First:


Middle:


Last:

Business:

*Title:


*Company:


*Describe Firm's Activity:


*Business Address:


*City:


*State:


*Zip:


*Email Address:


*Website Address:


*Business Phone:


*Cell Phone:


*Fax:


*I Prefer Mail be Sent to My:
    

Personal:

*Home Address:


*City:


*State:


*Zip:


*Home Phone:


*Applicant's Birthday:
( ex: MM/DD/YY )

*Education:(Check all that apply)

Other:
 

*College Name/Degrees/Years:
Degree 1:

Degree 2:

Degree 3:

*Are you a UT Alum?:


*Is your spouse a UT Alum?:


Spouse's Name:



*Professional or Service Club Affiliations
and role that you play in each organization:



*Interests:


*Proposed/Referred By:


*Why do you want to join the Board of Fellows?