Beck Collegiate "Roll Call"
The "Roll Call" form requests Beck Alumni (Students & Staff of the former "Sir Adam Beck Collegiate" in London Ontario Canada) to identify, or update, their current "Contact Information".

All information is held in the strictest confidence and is only used for contacting you for "Beck related events" (Reunion, Singing Auditorium, etc.).

• Please input all applicable lines - especially a primary email address if possible (email is our normal mode of contact).
NOTE - we keep a separate record for “each” alumni. When 2 alumni (spouses, etc.) share the same address we record
it for both.

• For emails it is best if:
- Each alumni (of a couple) identifies their own email. Thus, if one fails for some reason the other email will still receive
the message.
- You use a personal email address as opposed to one where you are employed.
- If submitting information about another person then show your name in the "Submitted By" field.

First Name *
Your answer
Surname (maiden name at Beck) *
Your answer
Married Name (current last name) *
Your answer
Spouse/Partner's First Name *
Your answer
If Spouse attended Beck then their last name at Beck
Your answer
Type (Student, Teacher or Both) *
Your answer
Years attended (example 58-62) *
Your answer
Year you would have or did graduate. (If you left school early what year did your class graduate) *
Your answer
Street/Mailing Address *
Your answer
City *
Your answer
Province/State *
Your answer
Postal/Zip Code *
Your answer
Country *
Your answer
eMail *
Your answer
Home Phone Number *
Your answer
How are you listed in the Telephone Directory (your name) *
Your answer
Notes
Your answer
Submitted By *
Your answer
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