Alumni Name Update

Class:

(Required)

Diploma:

Did You Receive a Diploma From Radford High School:

Name:

Last Name: (Required)
First Name: (Required)
Nickname:
Middle Name:
Suffix:
Ladies Married Name:
Spouses First Name:

Email Addresses:

Email 1: (Required)
Email 2:
Website:
AIM - AOL Instant Messenger
ICQ
IRC
MSN Instant Messenger
Yahoo Y!

Home Address:

Street:
Street:
City:
State:
Zip:

Phone Numbers: (999)999-9999

Home Number:
Work Number:
Work Extension:
Cell Number:
Fax Number:
Other:

Comment:

Year Deceased:

Optional Information I have been requested to collect:

(None of this information will be on the website. It is for Reunion Coordinators only)

Social Security Number:
Date of Birth:
Anniversary:
Children:
Occupation:
Education:
Interest:
Awards, Honors and Achievements:
Reunion Suggestions & Comments: