Alumni Update Form

Please complete this form in its entirety

I do not want my information to be included in the LAKE ERIE magazine.

Name & Address                             This Is New Informaiton
Name (First, Last, Maiden):
Class Year:
Degree:
Birth Date:
Spouse's Name:
E-Mail Address:
Home Phone #:
Cell Phone #:
Address:
City:
State:
Zip:
Occupation                                       This Is New Information
Occupation/Title:
Employer (Full Name):
Address:
City:
State:
Zip:
Work #:
E-mail Adress:
Birth Announcement                        This Is New Information
Child's Name:	Male Female
Sibling's Name:	Male Female
Sibling's Name:	Male Female
Marriage Announcement                This Is New Information
Date of Marriage:
Honor or Achievement                      This Is New Information
Recent Honor/Achievement:
College Clubs/Organizations           This Is New Information
College Clubs/Organizations:
Other Information or Comments:
Please type verification image: