Alumni Directory Registration Form

By submitting your information, you consent to receive information from the Lassen Community College.

First Name

Last Name

Program

Year Attended

Address

Apartment/Suite

City

Province/State

Country

Postal Code/Zip

Telephone

I would like to be more involved. Please send me information.

Yes No

I am willing to have my name and phone number given to fellow Alumni for the purpose of class reunions, class directories, and Alumni Events

Yes No

Would you like to rceive our mailer for "specials" on campus events, newsletters, and discounts?

Yes No

How would you like to be contacted?

Email U.S. Postal Service Phone

Employer

Employer Address

Position

Share it with us! Are you getting married? Starting a family? Got a new job promotion? Looking for an old classmate? Let us know what's going on in your life and if possible, send us a photo! Add your comments here.

Please indicate any of the above information you do not wish printed in Alumni publications.