2006 Survey

College and Alumni Relations

Personal Information:

Last Name
First Name
Middle Initial
Street Address
Apartment
City State Zip Country

Preferred Phone Number (xxx-xxx-xxxx) Type:

Preferred Email Type:
How do you prefer to be contacted: E-mail Phone Mail

Click here to join the 2006 listserv!

Spouse/ Partner
Spouse/ Partner's class year
Marriage/Union Date: (mm/dd/yyyy)

Children:
Name: Last First Middle Initial
Gender MaleFemale

Name: Last First Middle Initial
Gender MaleFemale

Employment Information:

Position/Title
Company/Employer Name

Business Address:
Street
Suite
City State Zip
Country
Business Phone Number (xxx-xxx-xxxx)

Starting employment date: Month Year
Does your employer have a Matching Gift Program? Yes No
If you do not know if your employer has a Matching Gift Program, CLICK HERE to check.

Post-Graduate Volunteer Service (i.e., Peace Corps, Teach for America, etc.):

Organization Name
Position/Title
Beginning Date: Month Year
Ending Date: Month Year

Graduate School Information:

Institution Name:
Degree Seeking: Academic Field:
Proposed Completion Date: Month Year

Are you interested in helping Grinnell College in any of the following areas? Check all that apply.

Class Agent Class Fund Director Regional Planning Committee
GRASP (Admissions) Volunteer Alumni Association Council
Class Committee (Class Fundraising, Reunion Planning and Class Letters)

Click Here to Learn More About Grinnell Volunteer Opportunities

Check all online communities for which you are an active member:

PLANS myspace Facebook Private blogs

Who have you kept in touch with from Grinnell?

1)
2)
3)
4)

If you had a million dollars to give to Grinnell, how would you like the College
to use your money in a way that would be meaningful to you?

Grinnell, IA 50112-1690

641-269-4000