Clarion University - Alumni Relations

Alumni Information Update Form
Please provide us with your most recent contact, employment, and family information. Be sure to include any recent awards you've won, interesting stories, and information about other personal successes.

UPDATE FORM

Please check one:

Please note: Data in the yellow shaded portion below is for Alumni Office use only and not for publication in Clarion & Beyond. Gray portions of the form are used in updates for publication, so please fill them out completely and accurately.

For publication in Clarion & Beyond
For alumni files online, not for publication

My First Name
My Middle Initial
My Last Name
My Maiden Name
My Graduation Year
My Major

My Home Phone
My Work Phone
My Cell Phone
My Home Fax
My Work Fax
My Home Email
My Work Email
Prior to publication, the Alumni Office will contact you to verify information in the update. What is the best time to contact you for verification?
Day of Week
Time of Day
Birth Date	Month Day Year
My Home Street Address

My Home City
My Home State
My Home Zip
My Home Country
My Spouse's Name (maiden, if alumnus)
My Spouse's Graduation Year (if alumnus)
My Children's Names, Birth Dates, Gender
My new job, transfer, promotion
My Employer's Name and Address
My Position/Title
My Other Activities (New Degrees, Honors, Retirements, etc.)

Clarion University of Pennsylvania
Departments of Alumni Relations and Annual Funds
840 Wood Street
Clarion, PA 16214
P: 814-393-2572
F: 814-393-1834
E: alumni@clarion.edu