Alumni Directory Registration

First Name *

Last Name *

Maiden Name

Birth Date

Street Address

City

State

Zip Code *

Country

Email *

Phone

Add to Online Directory?

Yes

Please add my name and e-mail address to the Online Alumni Directory and send logon information to my e-mail address. Only your name and email address will be listed.

Attendance at Lincoln College

Date From

Date To

Date From

Date To

Class year I prefer to be associated with:

Degrees Received (Other than at Lincoln)

School 1

Date

Major

Degree

School 2

Date

Major

Degree

Employment Information

Employer's Name

Business Type

Title/Position

Street Address

City

State

Zip Code

Phone

Fax

Work Web Site

Submit this employment information as a class note for The Log newsletter?

Yes, please submit

Family Information

Marital Status

Spouse's Name

Maiden Name

Date of Marriage

Spouse's Undergraduate School

Did your spouse attend Lincoln College?

Yes

Spouse's Graduation Year

Spouse's Employer

Spouse's Title

Employer's Street Address

Spouse's Work Phone

Spouse's Email

Children's names, birth dates, and high school graduation year (If any of your children attended Lincoln College, please note the dates attended):

Name, relationship, and class of relatives who have attended Lincoln College:

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