Mount Vernon Nazarene University - Alumni Questionnaire, Form

Please fill out the following information and press the submit button. Required fields are marked with asterisks.

On-line registration will close Wednesday, January 14, 2009

Date Attending*:
First Name*:
Last Name*:
Email*:
Address*:
City*:
State*:
Zip*:
Phone*:
Cell Phone:
Academic Interest*:
Number Attending*:
T-Shirt Size*:
Graduation Year from High School:
Birth date*:	Month Day Year
Gender*:
I would like to take an 8:15 a.m. campus tour*:	Yes No
Are your parents alums?	Yes No
Additional Comments:
A confirmation email will be sent to the email address you provide. If you do not enter an email address a confirmation letter will be sent to your mailing address as long as time allows before the event. Please let us know if you need to cancel your registration. *Required fields