Stebbins Athletic Boosters MembershiP
First Name	Last Name
Street Address
City	State	Zip
Email	Telephone
Spouse/Significant Other/Partner Name (if joining as member)
How would you like your listing on the website to read?
e.g. The Smith Family, Joe & Betty Smith, etc. The default will be your full name as listed on this form.
Are you or your spouse/significant other/partner an Alumnus of Stebbins High School?
You ☐	Year Graduated
Spouse/Significant Other/Partner ☐	Year Graduated
Spouse/Significant Other/Partner Name
Do you or your spouse/significant other/partner have children that graduated from Stebbins?
You ☐ Spouse ☐
Name	Year Graduated
Name	Year Graduated
Name	Year Graduated
Name	Year Graduated
Name	Year Graduated
Name	Year Graduated
Payment and completed form can be sent by mail to: Stebbins Athletic Boosters 1900 Harshman Road Riverside, OH 45424 Make checks payable to: Stebbins Athletic Boosters	Alternative method: Email form to: westebbinsathleticboosters@gmail.com Scan and pay through Venmo:
Annual Dues: $25.00 per person