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Alumni Athlete Information Form

We want to hear from you!
If you were once affiliated with the Mules and/or Jennies and have lost contact with your sport or other area associated with Athletics, please take a few minutes to complete this form and submit it to us.
(This information will not be made public nor will your address be distributed to any outside parties without your consent)

Note: Use your mouse or the tab key to go from one blank to the next as hitting the enter key may submit the form prematurely.

Name
Maiden Name (if applicable)
Street Address
City
State
Postal Code
Country (if outside USA)
Telephone Number (w/AC)
E-Mail Address
What and when was your affiliation with Central Missouri? (check all that apply):	Athlete	Years:
	Manager	Years:
	Coach	Years:
	Trainer	Years:
	Other (specify below)	Years:
If you were an athlete, manager or coach, what was your sport or sports?
Are you a Central Missouri graduate?	Yes   No
If so, year of graduation
Degree(s) Earned
Spouse's Name
Spouse's Maiden Name (if applicable)
Is your spouse a Central Missouri graduate?	Yes  No
If so, year of graduation
Degree(s) Earned
Would you like to receive information concerning alumni activities for your sport?	Yes   No
If so, how do you prefer to be contacted?	By E-mail  By Mail
(Optional) Finally, please tell us something about you (include anything newsworthy, such as present employment, job promotions, honors and awards, marriages, births, deaths, etc.):
Would you like us to also provide the above information to the UCM Office of Alumni Relations for inclusion in an upcoming issue of UCM Today? Yes, send my complete information to Alumni Relations, OR Yes, send only my address information to Alumni Relations No thanks, just send my information to the appropriate area in Athletics.

Note: Hitting "reset" clears the entire registration form; hitting "submit" sends it to us and sends you to a "Form Confirmation" page, which means that your registration form was successfully sent to us and that you DO NOT need to submit another one unless there was an error in the information you provided or you are submitting information on more than one person. Thank you!