Mailing List & Data Request Form

SALUTATIONSALUTATION #1 (Mr. and Mrs. John B. Smith, Jr.)SALUTATION #2 (Mr. John and Mrs. Ellen Smith)SALUTATION #3 (John B. Smith, Jr.)SALUTATION #4 (John Smith ’80)OTHER SALUTATION: ________________________________________________________ADDRESS/PHONEHOME ADDRESSBUSINESS ADDRESSPREFERRED ADDRESSHOME PHONEBUSINESS PHONEE-MAILOTHER: ________________________________________________________________________INDIVIDUALS / ALUMNIEDUCATION INFOCOLLEGECLASS OFDEGREEMAJOREMPLOYMENT INFO(Self-reported; may not be up to date.)SPOUSESCOMBINE SPOUSESDO NOT COMBINE SPOUSESOTHER: ________________________________________________________________________COMPANIES/ORGANIZATIONSPRIMARY CONTACTSECONDARY CONTACTINCLUDE SALUTATIONOTHER: ________________________________________________________________________