Alumni & Friends Update Record Form

We are so glad you are part of the Prairie Alumni Community! Please share your most up-to-date contact details with us, so that we can keep you updated with exciting news with students, programs and other alumni & friends.

Current Name*

First NameMiddle NameLast Name

Has your name changed since leaving Prairie?

YesNo

Maiden Name or Former Name

School(s), Years of Attendance/Work, & Grad Year (if applicable)

Spouse's Name (if applicable)

Email

example@example.com

Phone Number*

Area CodePhone Number

Preferred Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

I authorize and give Prairie permission to share my contact information with other alumni.*

YesNo

To assist in keeping our database up to date, would you also share with us about your current employment? If you are unemployed or retired, you can skip to the next page.

Yes, I will share about my current employment

Current Title or Position

Dates of Employment

Employer/Company Name

Will your employer match gifts to Prairie?

YesNoI don't know

Business/Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business Phone Number

Area CodePhone Number

Business Email

example@example.com

I authorize and give Prairie permission to share my employment information with other alumni.

YesNo

Update Your Information

Update Your Personal Details