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Alumni Directory Registration Form

 

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

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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.


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