Alumni Form

Rochester Childfirst Network Alumni Information Form
Thank you for taking time to fill out this survey.

Our goal is to:
1) Collect and record information about our alumni
2) Connect with our alumni to share their story
Your Full Name

First NameLast Name
Are you an RCN Alum or a parent/guardian of an RCN alum?
Name of the student who attended RCN

First NameLast Name
Year(s) at RCN as a student (approximate if unknown)
E-mail
Phone Number
Format: (000) 000-0000.
Current Location

Street Address

Street Address Line 2

CityState

Zip Code
How did you hear about this survey?
Other:
What do you remember the most about RCN?
Can we contact you to learn more about your experience at RCN?
Would you like to stay in touch through our monthly digital newsletter?
Lead Source
Lead Source attribution (DO NOT DELETE)
Privacy Notice: The information you provide will be used only by Rochester Childfirst Network to contact you regarding your interest in sharing your RCN story. We will not sell your personal information or share it outside the organization.
Should be Empty:

Rochester Childfirst Network Alumni Information Form