Winter 2007 - Lake Erie College

I do not want my information to be included in the LAKE ERIE magazine.
NAME last name/first/middle/maiden
SPOUSE last name/first/middle/maiden
HOME ADDRESS number/street/apartment/city/state/zip
TELEPHONE
OCCUPATION title
ADDRESS number/street/apartment/city/state/zip
CLASS YEAR
CLASS YEAR
(if from LEC)
THIS IS NEW INFORMATION
You may publish my e-mail address on the LEC website.
E-MAIL ADDRESS
EMPLOYER full name
DEGREE
DEGREE
(if from LEC)
TELEPHONE/E-MAIL ADDRESS
BIRTH DATE
BIRTH DATE
THIS IS NEW INFORMATION
Help us to keep our
records up-to-date and
allow us to share your
information with the
LEC family. Send this
form to:
Lake Erie College
Office of Alumni Relations
391 W. Washington St.
Painesville, Oh 44077
or you can reach us at:
alumni@lec.edu
440.375.7224
800.533.4996
You also may update
your information
online at:
www.lec.edu/alumni
Pictures are welcome!
SPOUSE’S OCCUPATION title
SPOUSE’S EMPLOYER full name
They will be used at the
SPOUSE’S ADDRESS number/street/apartment/city/state/zip
SPOUSE’S TELEPHONE/E-MAIL ADDRESS
discretion of the magazine
staff, if space allows.
Child’s Name:
Sibling’s Name
THIS IS NEW INFORMATION
MALE FEMALE DOB:
month/day/year
MALE FEMALE DOB:
month/day/year
Pictures can also be sent
via email at:
alumni@lec.edu
Sibling’s Name:
MALE FEMALE DOB:
month/day/year
DATE OF MARRIAGE:
RECENT HONOR OR ACHIEVEMENT:
MY NOMINATION FOR NATIONAL ALUMNI BOARD:
MY NOMINATION FOR ATHLETIC HALL OF FAME OR DISTINGUISHED ALUMNI AWARD:
If you need additional space attach more pages.