Lincoln College Alumni Association
Alumni Information Registration Form

Please complete the following form to submit your information to the Lincoln College Alumni Association.

This information will be submitted using a secure online connection.
Personal Information
Title:
(R) First Name/MI:
(R) Last Name:
Maiden Name:
Birth Date:
Street Address:
City:
State:
(R) ZIP Code:
Country:
Home Phone:
(R) E-mail:
 
  Please add my name and e-mail address to the Online Alumni Directory and send logon information to my e-mail address. Only items in bold will be included in your online directory lisiting.
Attendance at Lincoln College
Dates of Attendance:
 To:
  To:
 Class year I prefer to be associated with:
  
Degrees Received (other than Lincoln College)
School 1 :
Date:
Major:
Degree:
   
School 2 :
Date:
Major:
Degree:

Employment Information
Employer's Name:
Business Type:
Title/Position:
Address:
City:
State:
ZIP Code:
Work Phone:
Work Fax:
Work Website:
 
 Please submit this employment information as a class note for The Log newsletter.  
Family Information
Marital Status:
Spouse's Name
Maiden Name:
Date of Marriage:
Spouse's Undergraduate School:
Spouse attended Lincoln College:
Spouse's Graduation Year:
Spouse's Employer:
Spouse's Title/Position:
Spouse's Work Address:
Spouse's Work Phone:
Spouse's Home E-mail:
 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:   
   
(R) Enter the security code EXACTLY as it appears.
 
Thank you!