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?
Name - Month Day, Year
When is your Birthday?
Employment Information
Job Title
Employer Name
Work Phone
Fax Number
Alumni Notes
Send in your latest informationand news for us to pass along to your fellow alums:
- professional / personal / service accomplishments -
- who married who, when -
- who had a baby -
What's new with you?
Would you like to receive M&G?
Maroon & Gold newsletter (e-mailed to you)
I have other concerns and questions>