South Hills Alumni Association

Identification:
*First Name:
*Last Name:
Maiden Name:
*Address:
*City:
*State:
*Zip:
*Phone Number:
*Email Address:

Program:
*Class of:
Graduated from: State College Philipsburg Lewistown Altoona

Current Employment:
Place of Employment:
Job Title:
Address:
City:
State:
Zip:
Phone Number:

You have my permission to use my picture and
any information for release for alumni purposes. 		Yes No

I would like to receive the Alumni Newsletter by: Email Mail

I can help the Alumni Association by:
Helping with phonathons
Helping to locate classmates
Becoming a committee member
Assisting in special speaking events
Helping with Career Services (career fair)

I am interested in:
Participating in the annual craft show (Nov.)
Taking part in the alumni reunion
Participating in the Relay for Life team cancer walk
Taking evening certification classes


* denotes a required field