Alvernia College / Alumni Affairs

Alumni update

Please help us to keep the information on our alumni database current. Use this form to send us changes in your address and/or phone number. Update us on any new employment information, change in your marital status, new addition to your family, and/or honor or award that you received.

Personal Information

*	Last name:
	Maiden Name:
*	First name:
	Middle Initial:
*	Class Year:
	Social Security Number:	(For identification purposes only!)
	Home Address:
	City:
	State:
	Zip:
	Email:
	Home Phone:
	Is this a change of address?:	Yes No

* This information is required

Employment Information

	Company/Employer Name:
	Job Title:
	Address:
	City, State Zip Code:
	Business Phone:
	Email Address:
	Spouse's Name:
	Spouse's Employer:
	Spouse's Job Title:
	Children and birthdates:
	News for the next Alvernia College Magazine:

I want to help!

I am interested in:

Yes No       Helping to plan my class reunion.
Yes No       Serving on the Alumni Board or subcommittee
Yes No       Hosting an area alumni gathering my home
Yes No       Helping with the Phonathon
Yes No       Helping the Admissions Office with recruitment

Would you like to receive future Alumni mailings via email (i.e. newsletters, upcoming events, etc.)?

Yes No

Your comments are welcome.