*R E Q U I R E D   F I E L D S are in red

Name*:    Friar Class*:

Preferred Email Address*:

Home Telephone*:
 
Home Address*:    

City*:
State*: Zip*:

Country if not USA:

Check if above is a new permanent change for alumni records to know

Cell Phone (if okay to share):    

Website (if you have one to promote):    

Job Title:

Company Name:  

Area(s) of Expertise:

Willing to be a Network Source? (to offer guidance/advice/maybe job help):
Yes , happy to talk to a fellow Friar!   

For a new feature in the directory, a professional index, under what category would you ideally list yourself? e.g. consultant, surgeon, non-profit professional etc.

Work Telephone :

(The following Work Address information is purely for our records, not to be printed in directory unless this is your preferred address choice):
Work Address
Work City:
Work State: Work Zip:

Work Country if not USA:


Preferred Address to send Scrolls and list in the Directory:
HOME    WORK  


PERSONAL INFO: (please fill out all that applies)

Spouse Name (use maiden name for wives):

or Partner Name:


If spouse/partner is a Penn alum, list school and year here (C82 etc.) :
Your wedding/union date (eg. June 21, 1967 or June, 1967)

Number of Kids and ages as of April, 2011 (and list if any are Penn grads):
If you don't mind mentioning names, we will try to include that too.
*Format this can take: . 1 son aged 13, 1 daughter aged 4 OR 3 kids aged 20, 15 and 5 OR Max, 16; Sam, 12; Jillian, 2 OR 4 children, 10 grandchildren

Complete the phrase, Since Penn:
(INQUIRING FRIARS WANT TO KNOW!)


AND in case your Penn affiliations in the last directory weren't completely accurate, fill any or all of the following fields out as well.

My activities, roles and honors at Penn:


My honors at Penn SINCE graduation:



IF YOU WANT ANY OF THE ABOVE INFORMATION LEFT OUT OF THE NEXT DIRECTORY PLEASE NOTE SPECIFICS HERE:
e.g. Don't print cell phone or leave out address line

IS THERE IS ANYTHING ELSE YOU WANT TO SHARE/ADD THAT WASN'T COVERED BY A QUESTION ABOVE? IF SO LIST HERE

ALMOST AT THE END......two more minutes!

These LAST questions will be posted on a separate page in the directory.
They are completely OPTIONAL but appreciate your response ! If you don't care to answer, go to the bottom and click SUBMIT!

Most Vivid Friar Memory?
Any Friar Trivia to share?

Finish the sentence, “The best part of Friars was:
How many/what Friar events have you gone to since graduation
How many Friar classmates do you keep in touch with?
How many of these people did you know before Friars?
Do you have any photos we could use in the directory

And finally, would you be willing to call your Friar classmates to help us update our records if needed?

NOW press the submit button....reset erases the ENTIRE form and you will have to restart all over!