Alumni Check In Form

Name*With middle initials if any, e.g. Peter B Parker

Address #1*

Address #2Apartment/ Lot no.

City*

State*

Zip Code*

Phone Number*

Fax numberIf applicable

Email Address

Currently attending

School

College

Not Applicable

Major(s)/Area(s) of StudyIf in college

College Status

Freshman

Sophmore

Junior

Senior

If applicable

Anticipated graduation dateIf applicable

Degrees recieved

Diploma Certificate

Associates Degree

Bachelor's Degree

Master's Degree

Other

If applicable

Current EmployerIf applicable

Position TitleIf applicable

Work addresse.g. 1845 Fairmount St, Wichita, KS 67260

Have you visited our Facebook page in the last 6 months?

Yes

No

Commentse.g. If you could tell current EOC Participants one thing or give them one piece of advice, what would it be?

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