Alumni Information Submittal Form



Personal Information
Title:
First Name
 Last Name
 MI
Maiden Name
 Suffix
Spouse
Address
City
 State
 Zip
Province
E-mail
 Home Phone
. .
International Address
Graduation Year
 Birth Date

Would you like to recieve 'A Malone Moment' - the alumni email newsletter?
Yes  No
If yes, enter the email address at which you would like to receive 'A Malone Moment'
Job Information
Company
Address
City
 State
 Zip
Province
 Phone
. . x
Job Title
 Department


Does Malone College have permission to put this information in the online alumni
directory, or do you prefer that the information be used for internal purposes only?

Yes, I give permission for this information to be online 

I prefer that this information is used for internal purposes only
 
1.800.521.1146