Membership Application Form

Membership Application Form

Connect. Empower. Engage. We are LSUS Pilots Impacting Meaningful Change.
Welcome to a wealth of reasouces via the LSUS Pilot network! The LSUS Alumni Association covers the first year of membership for new graduates. Thereafter alumni can get continued access to benefits by becoming a dues-paying member. Membership subscriptions auto renew annually and can be cancelled at any time. Alumni business memberships include select opportunities to promote products and services.
New Graduate (Graduated after May 2025)- $0Alumni Individual - $50Alumni Family - $75Alumni Business - $125Lifetime Membership - $1000

Name

PrefixFirst NameMiddle NameLast NameSuffix
Titles or Certifications
(M.D., Ph.D., CPA, etc.)
Preferred Pronouns
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
International Contact Number
Birth Date

MonthDayYear
Partner/Spouse

First NameLast Name
Family Member

First NameLast Name
Corporate/Community Partner
Alumni Business
Point of Contact

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Website

All annual membership subscriptions auto-renew. Membership may be cancelled at anytime by contacting alumni@lsus.edu.
Credit CardCheck or Money Order
Lifetime Membership Payment Link

LSUS Alumni Association Membership Level

Individual Membership

$50.00 for each year

Family Membership

$75.00 for each year

Alumni Business

$125.00 for each year