Personal Information
Relationship to SOU 

Relationship to SOU* 

Class Year Undergraduate 

IF APPLICABLE
Class Year Graduate 

IF APPLICABLE
Department or major 

Preferred Title 

  

FIRST NAME
  

MIDDLE NAME
 * 

LAST NAME
  

SUFFIX
Maiden Name 

if applicable
Preferred Title 

  

SPOUSE OR SIGNFICANT OTHER NAME
Family member attended/attending SOU 

NAME AND RELATIONSHIP TO YOU
Email
  

EMAIL
  

CONFIRM EMAIL
SEND E-NEWSLETTER? 
Phone
  

HOME PHONE
  

CELL PHONE
Home Address
 * 

ADDRESS 1
  

ADDRESS 2
 * 

CITY
 * 

STATE
 * 

ZIP
  

COUNTRY (if not USA)
Employment Information
  

EMPLOYER NAME
  

TITLE
Business Email
  

BUSINESS EMAIL
  

CONFIRM BUSINESS EMAIL
Business Phone
  

BUSINESS PHONE
  

BUSINESS FAX
Business Address
  

BUSINESS ADDRESS 1
  

BUSINESS ADDRESS 2
  

CITY
  

STATE
  

ZIP
  

COUNTRY (if not USA)
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