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First Name:
Last Name:
Maiden Name:
Did you Attend: JCA SCA SGS
Class Year:
Birthdate:
Home Address:
City | State | Zip: | |
Phone:
(555-123-4567)
Fax:
Email:
Graduate Degree:
College / University:
Year Received:

Employment Information
Employer:
Title:
Business Address:
City | State | Zip: | |
Phone:
Fax:

Spouse / Partner Information
Name:
Birthdate:
Wedding Date:
(if applicable)
Employer:
Title:

Children / Relatives
Children:
(Name, Birthdate, M/F, School(s) Attended)
Relatives who attend or have attended JCA, SCA, or SGS:
(Name, Relationship, Date of Graduation)
Would you be interested in taking part in Alumni Events and if so, what events would you like to see offered?
Happy Hours/Socials Day Trips Volunteering Events
Sporting Events Speakers on Campus Educational/Cultural
Networking & Career Art Shows & Exhibits
For planning purposes, please check the times which are most convenient for you to attend an event:
Monday Evenings Thursday Evenings Saturday Evenings
Tuesday Evenings Friday Evenings Sunday Afternoons
Wednesday Evenings Saturday Afternoons Sunday Evenings
Would you be interested in helping plan future alumni events in your area? If so, how can we best contact you?
Would you like to be included in our Alumni Admissions Program to recruit prospective students? If so, how can we best contact you?