Membership Application

The Order of Sparta

(Please complete thoroughly and return with your membership commitment)


Name______________________________________________________________


Preferred Mailing Address______________________________________________


City_____________________ State________________ Zip__________________


Day Phone____________________ Home Phone___________________________


Email Address________________________________________________________


Business/Title (optional)________________________________________________


Which Sport(s) played__________________________________________________


Which year(s) played______________________ Grad. Year___________________


Membership fee: $50 per year – July 1- June 30

Amount Enclosed: $_________

Please make checks payable to SJSU, The Order of Sparta

Or charge to:

MasterCard/Visa (circle one) #: ___________________________________________

Name on Account: ____________________________________ Exp. Date: ________


Return this form with your payment to:

SJSU Department of Athletics
The Order of Sparta
One Washington Square
San Jose, CA 95192-0062
Phone: (408) 924-1692
Fax: (408) 924-1291
Email: sbragg@email.sjsu.edu