Information about yourself
    Name  (First Middle Maiden Last):  
    Class Year(s):       
    E-mail address: 


  Home Address
    Street: 
    City:      State:    Zip: 
    Home Phone:    


  Business Address
    Employer:     Title:  
    Street: 
    City:      State:    Zip: 
    Work Phone:    


  Information about your spouse
    Spouse's Name  (First Middle Maiden Last): 

    Complete the following if spouse is an alumnus of JSU

    Spouse's Class Year(s):           

    Business Address
    Employer:     Title:  
    Street: 
    City:      State:    Zip: 
    Work Phone:    

  Information about your children
    Please include Complete Name(s), Date(s) of Birth and
    If JSU grad, year(s) of graduation


  JSU Organization/Sports Affiliation (check all that apply)
     I was a member of:
     Football   Baseball    Basketball(Men) Basketball(Women)
     Gymnastics Tennis(Men) Tennis(Women)   Volleyball
     Softball   Rifle       Cross C/Track   Soccer
     Golf       Wrestling   Cheerleaders    Fastbreakers
     Band       Ballerinas  Fraternity      Sorority
     Which Fraternity/Sorority 
     Other Organizations: 
  Please make any comments or suggestions here: