Purdue Alumni Association-PASE

Availability:

In Stock

One-time

Please fill out all fields below and then click "Give Now". After you submit your payment, you will receive a receipt to your email. Students will need to stop by the Boilermaker Station Welcome Center, Stewart Center 102 to pick up their jacket and membership kit. An email will be sent to them with a link to request their jacket and kit. If you have any questions, please contact our general email: PASE@purdueforlife.org

Student First Name:

Student Last Name:

Student Purdue E-mail:

Student Cell Phone Number:

Do not include any dashes within the phone number. International students can omit the country code. Example: 8003192199

Student Date of Birth:

Student PUID:

This is your Purdue ID number with two leading zeros

Student Gender:

Home Street Address:

Home City:

Home State:

Home Country:

Home Zip Code:

Parent/Guardian E-mail:

Name of Individual Purchasing Membership (name on purchasing card):