Alumni Information Form
* Required
First Name
*
Your answer
Last Name
*
Your answer
Middle Name (Initial) or Maiden
Your answer
Full Name while at City As School HS (leave blank if same)
Your answer
Title
Mr., Mrs., Dr., Capt., etc.
Your answer
Suffix
Jr., Ph.D., M.D., Esq., II, III, etc.
Your answer
Would you like to join the CASAA planning committee?
Yes
No
Clear selection
Please tells us your affiliation with City-As-School High School
Current Student
Former Student
Parent or Relative
Current/Former Faculty
Supporter
Occupation
Your answer
Primary Email
*
Your answer
Speaker
*
Your answer
CASAA will run mailings for news and special events. Please provide a Postal Address to facilitate this.
*
Indicate your preferred postal address
Home
Work
Please enter your postal address, (including APT#)
*
Your answer
Please enter your home phone number
Your answer
Please enter your work phone number
Your answer
Please enter your cell phone number
Your answer
Please enter your cell phone provider
This will allow us to communicate with you via text message
Your answer
Please enter the year you will/would have/did graduate, ex.: 2002, 1970, Jan 1951, Jun 1932
*
Your answer
Donate
*
Your answer
Check to indicate that you would like to provide support to the school and our current population in the following areas:
Mentoring and Tutoring
Guest Alumni Speakers; Speaker's Bureau
New Internship Placements
Scholarships and Awards
Financial Support for Ongoing Student Activities, Including Trips
Assistance with Computer Programming/web design/graphic design
Donation of Resources and Materials
Meeting Facilities
Corporate Support
Other:
Mentoring
Your answer
PLEASE SHARE THIS FORM WITH OTHER ALUMNI!
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