Alumni Update
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1. Default Section
Please use this form to add your self to the registry, or update previously submitted information. If information is unchanged, you may leave it blank.
*
1
. Is this a new record or an update of an existing record?
Is this a new record or an update of an existing record?
New
Update
*
2
. Please type in your name here so we know which record to update/add.
Please type in your name here so we know which record to update/add.
Name:
3
. Please provide us with new/updated HOME information.
Please provide us with new/updated HOME information.
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
Country:
Personal Email Address:
Home Phone Number:
4
. May we add your email address to the list serve so that you receive the JMCnews, the monthly alumni e-newsletter?
May we add your email address to the list serve so that you receive the JMCnews, the monthly alumni e-newsletter?
Yes
No
5
. May we post your HOME information on the Alumni Registry on the JMC Webpage, or just to our internal private database.
May we post your HOME information on the Alumni Registry on the JMC Webpage, or just to our internal private database.
Internal Private Database Only
Internal Private Database AND Public Website Alumni Registry
Special instructions (for example, certain items of information may be used in certain ways)
6
. Please provide us with new/updated WORK information.
Please provide us with new/updated WORK information.
Position:
Company:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
Country:
Work Email Address:
Work Phone Number:
7
. May we post your WORK information on the Alumni Registry on the JMC Webpage, or just to our internal private database.
May we post your WORK information on the Alumni Registry on the JMC Webpage, or just to our internal private database.
Internal Private Database Only
Internal Private Database AND Public Website Alumni Registry
Special instructions (for example, certain items of information may be used in certain ways)
8
. Please provide us with updated demographic information:
Please provide us with updated demographic information:
Year
Major
Partner/Spouse Name
Maiden Name
9
. What are you up to? Can you provide a brief bio?
What are you up to? Can you provide a brief bio?
10
. May we use your bio information in an upcoming JMC Scene newsletter?
May we use your bio information in an upcoming JMC Scene newsletter?
Yes
No
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