Central S.T.A.F Online Bursar Bill Only Application

Important: Use this form only if you want to have your Central S.T.A.F. membership dues billed to your Student Bursar Account. Central S.T.A.F. membership is available for current UCO students only.

Fill out and submit this form to join or to renew your Central S.T.A.F. (Students Today, Alumni Forever) membership and have your membership dues charged to your UCO Student Bursar Account. Please provide us with your mailing address (and update us with new information if you move) so that we can make sure you will receive all of your mailings and information.

*Last Name:
*First Name:
UCO Student ID #:
*E-Mail Address:
*Your Mailing Address:
*City:
*State:
*Zip Code:
*Campus Phone Number (including area code):
*Cel or Home Phone Number (including area code):
Parent Last Name (if applicable):
Parent First Name (if applicable):
Parent Email Address:
Parent Mailing Address (if applicable):
Parent City (if applicable):
Parent State (if applicable):
Parent Zip Code (if applicable):
*T-Shirt Size:
Are you renewing your Central S.T.A.F. membership or are you joining for the first time?
*Joining or Renewing:
*How did you hear about joining Central S.T.A.F. online?:
If other, please specify:
Please charge my $15 Central S.T.A.F. membership dues for the Fall 2010/Spring 2011 year to my Student Bursar Account.
Charge Bursar Account:		Yes
To confirm that you wish to have $15 charged to your Student Bursar Account for your Central S.T.A.F. membership, please enter your full name (first, middle initial, and last) and today's date below.
*Student's Full Name:
*Today's Date:
Are you interested in volunteering your time at an Alumni Association event?
Volunteering:

University of

Central Oklahoma

Central S.T.A.F Online Bursar Bill Only Application