Current Contact Information

Personal E-Mail Address: (required) 

Prefix:  Full Name: Preferred Name: Maiden Name: Suffix:  Date of Birth:  Residence Address: City:  State:  MO N/A AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code:  Country (if not US):  Residence Phone #:  May we make your contact information available to other LU alumni through a directory in the future?  Yes    No

Undergraduate Degree: Major: Year Received:  Graduate Degree: Year Received:  Employer: Job Title: Business Address: City:  State:  MO N/A AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code:  Country (if not US): Business Phone #: Employer has a Matching Gift Program?  Yes    No

Education, Career Development, Professional Organization Information

List any other Institutions attended:

Institution: Degree: Dates of Attendance:

Institution: Degree: Dates of Attendance:

While you were at Lindenwood in which campus organizations did you participate?
(fraternity/sorority, clubs, varisty athletics, intramural teams, etc.)
  

List any awards/scholarships received:
  

Have you ever used the Lindenwood University Career Development Center to assist you in finding employment?
 Yes    No    N/A

List any memberships in professional organizations and Corporate/Foundation Boards:
  


Family Information

Spouse's Name: Date of Birth: Job Title: Spouse's Employer: Spouse's Employer has a Matching Gift Program?  Yes    No Spouse's College/University: Dates of Attendance: Degrees:

Name(s) and Date of Birth of Children:  DOB:  DOB:  DOB:  DOB:  DOB: Please list the Name, Address, and Phone Number of a person who would always know your address:

Preserving Our Heritage

Please select all items below that are of interest to you:
 I would be willing to participate in a Mentorship Program by sharing my professional experience with a student.

I would be willing to serve as a class agent to assist the Alumni Office with communication and events.

I am interested in learning more about Academic Programs at Lindenwood.

I would like more information about Campus Projects/Renovations.

I would enjoy hearing about student success stories.

I have made provision for Lindenwood in my estate plans.

I would like more information about planned giving.

Other

What would encourage you to return to campus for your class reunion?
  

Your comments, please. We value your opinion and want to hear from you.