Individual Package 2009

Full Name: *

Maiden Name:

Address: *

City: *

State: *

Zip: *

Email: *

Home Phone Number (with Area Code): *

Cell Phone Number (with Area Code):

Class Year: (YYYY) *

Major:
Accounting Actuarial Science American Politics Art Biology Biology/Science Secondary Education Business Chemistry Commercial/Public Recreation Computer Science Computer Science/Electronics Criminal Justice Economics Elementary Education English English/Language Arts Secondary Education Environmental Science Finance Fine Arts History History Human Resource Management International Business Liberal Studies Library Science Management Marketing Mass Communication: Media Arts (Graphics and Web) Mass Communication: Advertising/Public Relations Mass Communication: Broadcasting (Audio and Video) Mathematics/Secondary Education Medical Technology Music Natural Science Nuclear Medical Technology Nursing Pastoral Ministry Philosophy Political Science Pre-Dental Pre-Law Pre-Medical Pre-Pharmacy Pre-Physical Therapy Pre-Physician Assistant Pre-Veterinary Medicine Psychology Radiation Therapy Radiography Recreation Administration Social Work Social Science/Secondary Special Education Teaching Ministry Technology Management Theology Therapeutic Recreation Undecided Visual Arts: Graphic Design Visual Arts: Studio Art Visual Arts: Arts Management Visual Arts: Arts Marketing Visual Arts: Arts Public Relations Writing Select a Major

Please indicate which events you will attend (with an x) in the boxes below:

Payment Options:*

Option 1 – Credit Card Option 2 – Check

**Members of Class of 1959 and earlier are complimentary