Catholic Alumni Club of Pittsburgh

Application for Membership
 
 

 

 

NEW

RENEWAL

 

NAME:

LAST

     

 FIRST

     

 

 

ADDRESS:

STREET/BOX

     

 

 

 

CITY

     

STATE

  

ZIP

     

+

    

SEX:

M

F

 

PHONE:

HOME

(       )       -      

CELL

(       )       -      

BIRTHDATE:

     

 

E-MAIL ADDRESS:

     

 

 

If NEW, how did you learn about CAC of Pittsburgh?

     

 

 

HIGHEST DEGREE OBTAINED:

     

MAJOR(S):

     

 

SCHOOL(S) ATTENDED:

     

 

SCHOOL LOCATION(S):

     

YEAR GRADUATED:

    

 

 

The following questions determine your eligibility for membership within CAC.  Please answer them to the best of your knowledge.  All applicable questions must be completed or your application cannot be processed.   If you have difficulty, please consult the CAC Membership Coordinator or the Office of the Tribunal for the Diocese of Pittsburgh.

 

1.

Are you a member of the Catholic Church?

YES

NO

 

 

 

If “YES” to #1, what is your current home parish?

     

 

2.

Are you or have you ever been married?

YES

NO

 

 

3.

If “YES” to #2, have all of your previous marriages been either a) formally nullified by the Catholic Church,

 

b) declared invalid by the Catholic Church, or c) dissolved by death of spouse?

YES

NO

 

 

 

New members: If "YES" to #3, please enclose photocopies of all formal documentation (e.g. Decree of Nullity, Declaration of Defective Form, etc.) that confirms your eligibility for membership.

 

 

Check membership status for which you are qualified:  (NOTE: You must be at least 21 years of age and free to marry in the Catholic Church to qualify for any level of membership.)

 

FULL MEMBERSHIP

(free to marry, Catholic, minimum two-year degree or RN)

 

If you were an associate member elected to full membership, please check here:

YEAR ELECTED:

    

 

 

ASSOCIATE MEMBERSHIP

(free to marry, Catholic, no degree or RN)

 

SUBSCRIBER

(free to marry, non-Catholic)

 

** FULL members have voting privileges during elections for club officers and on club referendums.  ASSOCIATE members and SUBSCRIBERS do not have voting privileges.  SUBSCRIBERS are not recognized as members of CAC International, but are recognized as members of CAC of Pittsburgh.

 

 

For one year of membership, please send this FULLY COMPLETED application along with any necessary supporting documentation and a check or money order for $30.00, payable to "CAC of Pittsburgh", to:

CAC of Pittsburgh, c/o Mitchell Demchak, 408 S Highlander Heights Dr, Glenshaw, PA 15116-2567.

 

 

I CERTIFY THAT I AM 21 YEARS OF AGE OR OLDER AND THE INFORMATION GIVEN IS BOTH TRUE AND COMPLETE.  I UNDERSTAND THAT FALSIFICATION OF ANY INFORMATION WILL RESULT IN THE VOIDING OF THIS APPLICATION AND THE FORFEITURE OF ANY FEES PAID.  I ALSO RELEASE THE CATHOLIC ALUMNI CLUB, ITS MEMBERS, AND ITS OFFICERS FROM ANY SUITS OR CLAIMS THAT MAY RESULT FROM AN INJURY OR ACCIDENT WHILE ATTENDING A FUNCTION.  I UNDERSTAND THAT ALL INFORMATION GIVEN ABOVE IS CONFIDENTIAL AND IS NOT AVAILABLE TO THE GENERAL MEMBERSHIP.  AN INCOMPLETE APPLICATION CANNOT BE PROCESSED AND WILL BE RETURNED TO ME OR DISCARDED.

 

SIGNATURE:

 

DATE: