Elmira College : Update Your Alumni Record

UPDATE YOUR ALUMNI RECORD

Attention Alumni, Update Your Record Today!

To stay informed about what's going on at Elmira College and to help update our records, please fill out the form below as completely as possible. In order to plan and provide appropriate programs and services for alumni, we need complete and accurate home and business information. Your help is greatly appreciated. Thank you.

Items marked with an * are required.

Title:

First Name:*

M.I.:

Last:*

I prefer to be called:

EC Degree:

Class Year:*

Please add additional degree information in the comments at the end of this form.

Maiden:

Address1:*

Address2:

City:*

State:*

ZIP:*

Country:

Date of Birth:

Phone:*

( )

E-Mail Address:*

Relationship Status:

If married, date of marriage:

Name:

Is he/she an EC grad?:

Yes No

Degree:

Year:

Child(ren)'s name(s):

DOB:
DOB:
DOB:

Do you wish to have your home address information shared in Campus Magazine? *

Yes No

Company Name:
Your position/title:
Street:
City:
State:
ZIP/Postal:
Business Phone:	( ) Ext:
Fax:	( )
Address preference:	Home: Business:

Enter additional comments or requests below. Please indicate if you do not wish your news to be shared in Campus magazine, class notes.