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Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Maiden Name
Your answer
High School
*
Bentley High School
Churchill High School
Franklin High School
Stevenson High School
Western Wayne Skill Center
Year of Graduation (yyyy)
*
Your answer
Current Address
*
Your answer
Current City, State, ZIP
*
Your answer
Phone number
*
Your answer
Name of College / Trade School / Other you have attended / plan to attend
Your answer
Degree / Course of Study
Your answer
Employer
Your answer
Please let us know if you'd like to be involved in any of the following ways (select all that apply)
Speaking with current students (e.g. being on an alumni speaker panel)
Planning alumni events
Assisting with alumni communications
Serving on the Alumni Committee
Other:
Do you have a spouse who is an LPS alumna/alumnus?
Yes
No
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Spouse's name (include maiden name, if applicable)
Your answer
Spouse's email address (if applicable)
Your answer
Comments / Questions
Your answer
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