Name:
Address:
City: State: Zip Code:

Home Phone: Cell Phone: Email:

Preferred Method of Contact: Phone Email Mail
Which social networking sites do you use (i.e., Facebook, LinkedIn, MySpace, etc.):

Alumni Information:
Actual Year(s) you attended Herbert Hoover:
Your nickname(s), if applicable:
Activities participated in:
Most memorable experience(s):

People you remember (specify staff or other club members):

Contact information for past members still in touch with:

Are you interested in joining Alumni Association: Yes NO
Areas willing to assist/volunteer in with the Club:
Mentoring Fundraising/Special Events Volunteering for Programs
Coaching Special Events for Kids Other:
Suggested Activities for the Alumni Association to run/sponsor for the Club:


Family Information:
Marital Status: Single Married Divorced Widow
Spouse’s Name:
Names and Ages of Children:

Names and Ages of Grandchildren:


Employer Information: (Please complete this section or attach a business card.)
Employer Name:
Position:
Address:
City: State: Zip Code:
Work Phone: Work Email: