Harvard University National Capital Harvard Business School Club of Ottawa Alumni Club
2003-2004 Membership Application
Name (and title, if applicable)
Home Address:
Business Address:
Contact: Tel. Home: _____________________ Fax: _______________________
Tel. Business: ______________________ Fax: ________________________
E-mail address: __________________________________________________________
Where should Club mailings be directed? Home or Business
Harvard Degrees and years: _________________________________________________
Other Degrees (institution and year):__
Occupation: _________________________________________________
Professional/Business Interests: ___________________________________________________
Leisure Interests:
Spouse's Name: _________________________________________________
Include this information in the next Club Directory (2000)?
Activities you would like to see the Clubs organize. (Please include ideas for events you might like to coordinate or initiate.)
Type of Membership: Harvard university Club
(Select the Club to which Single ($35) Spousal ($40)
you would normally belong)
Harvard Business School Alumni Club
Single ($35) Spousal ($40)
Reduced rates for recent graduates (past five years): Single (FREE) Spousal ($5)
Please forward this completed form with cheque made out to "Harvard University Club of Ottawa" to:
Peter Kieran, Treasurer, do CPCS Transcom Ltd.
150 Isabella Street, Penthouse Floor, Ottawa, Ontario K 15 1
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