stay in Touch

Let us know where you are

 

Fill out any information you would like changed and submit this form so we may keep our records updated. Make sure you tell us your name and graduation year. This form will transmit your information directly to the alumni office:

 

Personal Information

First Name

Middle

Last Name

Maiden Name  

Preferred Grad Year  

Street Address   

City

State

Zip Code

Home Phone

Social Security #  (for Eureka College use only)

E-mail address   

Is your spouse an EC Graduate?  

Yes No

Spouse's name  

What are the names and birthdates of your children?

When is your Birthday?

 


Employment Information

Job Title 

Employer Name 

Work Phone

Fax Number


GALLIMAUFRY

Send in your information for GALLIMAUFRY,the section of our Alumni Publications that shares our

- professional / personal / service accomplishments -

- who married who, when -

- who had a baby -

 

If you would like additional information, please check the appropriate box:

Maroon & Gold newsletter (e-mailed to you)

Alumni Weekend

Homecoming Weekend

Please contact me