Alumni Registration List

Alumni Directory Registration Form

By submitting your information, you consent to receive information from the Lassen Community College.

First Name *

Last Name *

Program

Year Attended

Address

Apartment/Suite

City

Province/State

Country

Postal Code/Zip

Email

Telephone

I would like to be more involved.
Please send me information.

Yes

No

I am willing to have my name and phone number
given to fellow Alumni for the purpose of class reunions,
class directories, and Alumni Events

Yes

No

Would you like to rceive our mailer for "specials"
on campus events, newsletters, and discounts?

Yes

No

How would you like to be contacted?

Email

U.S. Postal Service

Phone

Employer

Employer Address

Position

Share it with us! Are you getting married? Starting
a family? Got a new job promotion? Looking for
an old classmate? Let us know what's going on
in your life and if possible, send us a photo!
Add your comments here.

Please indicate any of the above information you do
not wish printed in Alumni publications.

Attachments

Alumni Directory Registration Form

First Name *

Last Name *

Program

Year Attended

Address

Apartment/Suite

City

Province/State

Country

Postal Code/Zip

Email

Telephone

I would like to be more involved. Please send me information.

I am willing to have my name and phone number given to fellow Alumni for the purpose of class reunions, class directories, and Alumni Events

Would you like to rceive our mailer for "specials" on campus events, newsletters, and discounts?

How would you like to be contacted?

Employer

Employer Address

Position

Share it with us! Are you getting married? Starting a family? Got a new job promotion? Looking for an old classmate? Let us know what's going on in your life and if possible, send us a photo! Add your comments here.

Please indicate any of the above information you do not wish printed in Alumni publications.

I would like to be more involved.
Please send me information.

I am willing to have my name and phone number
given to fellow Alumni for the purpose of class reunions,
class directories, and Alumni Events

Would you like to rceive our mailer for "specials"
on campus events, newsletters, and discounts?

Share it with us! Are you getting married? Starting
a family? Got a new job promotion? Looking for
an old classmate? Let us know what's going on
in your life and if possible, send us a photo!
Add your comments here.

Please indicate any of the above information you do
not wish printed in Alumni publications.