SMCS Alumni Foundation

CONTACT INFORMATION

Class Year: * for those who did not graduate, please enter the graduating class with which you are affiliated.

Last Name:

First Name:

Middle Name:

Full name as student (in case of name change):

Street #

Street Name:

Apt. #:

City:

Province/State:

Region:

Country(if not in Canada or US):

Postal/Zip Code:

Residence Phone:

Mobile Phone:

Business Phone:

Residence Email:

Business Email:

Preferred Email:

Website URL: (entering "www" is not required) ______________________________________________________________

ACADEMIC HISTORY

Grade completed at SMCS:

Royal Conservatory Level Achieved:

Piano Organ

Violin Guitar

Voice

Post Secondary Information

Degree 1:

Institution:

Degree 2:

Institution:

Degree 3:

Institution:

____________________________________________________________

PROFESSIONAL INFORMATION

Job Title:

Occupation:

Company Name: Retired: ___________________________________________________________________________

FAMILY INFORMATION

Marital Status: Children:

Number of Children:

__________________________________________________________________

THE FOLLOWING INFORMATION IS FOR THE PRIVATE USE OF SMCSAF ONLY AND WILL NOT BE PRINTED IN ANY FUTURE DIRECTORY.

1. Would you be interested in participating in SMCSAF
activities?

2. Would you be interested in particpating in an Alumni Choir?

3. Do you prefer to hear from SMCSAF through
e-mail/Web communications or printed communications?

4. Would you consider donating to a scholarship fund?

5. Would you consider donating to SMCS?

6. Would you consider SMCS in your estate plan/will?

I do not wish to be included in the SMSCAF directory.

If you would like to CONTACT US or add any information which you believe is important, but was not included in this questionnaire, please enter it below.