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Alumni Information Form

"*" indicates required fields

First Name*

Middle Name

Last Name*

Nickname

Maiden Name

Attended

St. Johnsbury Academy

Mount St. Joseph

St. Johnsbury Trade School

Class Year

Birth Date

MM slash DD slash YYYY

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

I have a seasonal address

Seasonal Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Start date for seasonal

MM slash DD slash YYYY

End date for seasonal

MM slash DD slash YYYY

Marital Status

Single

Married

Divorced

Widowed

Other

Spouse Name

Prefix First Middle Last

Spouse Nickname

Spouse Maiden Name

Spouse Class Year

Spouse Employer

Spouse Job Title

Partner Name

Prefix First Middle Last

Partner Nickname

Partner Class Year

Preferred Phone**

This is my:**

Mobile Phone

Home Phone

Business Phone

Secondary Phone

This is my:

Mobile Phone

Home Phone

Business Phone

Preferred Email Address**

I would like to add/update additional school information

School

Degree

Major

Year

I would like to add another school

School

Degree

Major

Year

I would like to add/update my employment information

Employer

Job Title

Business Website

How long have you been employed with this company?

I would like to add/update information about my children

Child's Name

Child's Date of Birth

Child's Name

Child's Date of Birth

Child's Name

Child's Date of Birth

Please list additional children and/or anything else you would like to share about them.

I am interested in helping to plan future reunion events for my class

I have ideas/suggestions for future alumni events

Please provide detail on your ideas/suggestions

I am interested in receiving SJA admissions info for my child

Other Notes

Tell us about your family, what you are doing these days, or other exciting news you would like to share. You may also share what you remember most about your days at St. Johnsbury Academy.

Δ

Every gift is important and needed. Thank you for your generosity.

An independent, coeducational, boarding and day school for grades 9-12 and postgraduate year.

1000 Main Street

St. Johnsbury, Vermont 05819

(802) 748-8171

hilltoppers@stjacademy.org

49 Perkins Street

St. Johnsbury, Vermont 05819

(802) 751-2305

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