Name
Address
City, State, Zip
Telephone
E-mail
Social Security
Marital Status
Maiden Name
Date of Birth
Gender
Male
Female
Degree
Summary
Graduated from
FHSU (Year)
Degree and Major
Other degree
School
Date
Spouse
Full name (include
title & maiden name)
Marriage Date
Social Security
Number
Is spouse an
FHSU graduate?
Yes
No
If so, graduation
year(s)
If not, spouse's
university
Occupation
Employer
Business Address
Business Telephone
FAX
E-mail
Business
Employer
Occupation
Title
Business Telephone
Address
City, State,
Zip
FAX
E-mail
List
below the information of two people who will always know
your address (other than your spouse):
Title and Name
Address
City, State,
Zip
Telephone
Relationship
E-mail
Title and Name
Address
City, State,
Zip
Telephone
Relationship
E-mail
Student Activities/Organizations
while at FHSU:
Residence while
attending FHSU (name specific residence hall or Greek house)
Sport(s) participation
while at FHSU:
Children
Full Name
Gender
Birthdate
Relatives
who have attended FHSU
Full Name
Grad. Year
Relationship
If
called upon, I would be willing to assist the university
in the following areas:Your six-month FREE membership into the FHSU Alumni Association
includes numerous benefits .
Please send the following items at this time:
or
apply online )
Thank you - we truly appreciate
your commitment to Fort Hays State University!
