BECK Alumni "Roll Call"

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

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

- Pease 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.

- "Tab" key steps through the fields in sequence.

*First Name*
*Surname / Maiden Name (at Beck)*
*Married Name (or current Last Name)*
Spouse / Partner's First Name
If Spouse attended Beck? - last name at Beck
Alumni Type (Student / Teacher/ Both)
Years Attended (first & last - i.e. 58-63)
*"Year" of Graduation*
Street Address (incl. Apt #, etc.)
City
Province/State
Postal Code
Country - replace if other than Canada
*E-mail*
*Home Phone*
*How listed in Tel Directory (Name)*
Interested in helping with activities?
Notes:
Submitted by:

Thank you for joining our Alumni database. All information will remain confidential.

BECK Alumni "Roll Call"

Beck Reunion Committee. Revised: 01/11/12

Beck Reunion Committee.
Revised: 01/11/12