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Alumni Records Information Form
Please provide the following information for the ACU Alumni Association.

(* indicates a required field.)

* 1). Mr., Mrs., Ms., or Miss
* 2). First Name
3). Middle Name
* 4). Last Name
5). Preferred Given Name
6). Social Security #
7). Banner ID #
8). Degree
9). Major
10). Future Occupation
11). Dates I attended ACU
12). Class year I want to be associated with for my reunion
* 13). After graduation my mailing address will be: Street or Box
* 14). City
* 15). State
* 16). ZIP
* 17). Phone
18). My address can always be obtained from: Name
19). Relationship
20). Street or Box
21). City
22). State
23). ZIP
24). Phone
25). Are you married? (If yes, please complete the following information. If no, skip to #31) Yes No
26). Wife's Maiden Name (First, Middle, Last)
27). Attended ACU? Yes No
28). Husband's Name (First, Middle, Last)
29). Attended ACU? Yes No
30). Children's names and birth dates
31). If you participated in athletics at ACU, please list the name of the sport
32). If you participated in a Social Club at ACU, please list the name of the club
33). If you participated in a Departmental Club at ACU, please list the name of the club
34). If you participated in a Honor Club at ACU, please list the name of the club
35). If you participated in a Service Club at ACU, please list the name of the club
36). Please check any of the following you participated in at ACU Band
Orchestra
A Cappella
"W" Club
37). Please list honors, awards, or other activities at ACU