Longwood University Alumni Records Change Form *(Indicates a required field)

Check if:
New Address
New Marriage
New Business Information

Personal Information:

Prefix: Mr. Ms. Mrs. Miss Dr.
First Name: *
Middle Name:
Maiden Name:
Last Name: *
Suffix:
Year of Graduation:
Preferred Class Year:

Home Address:

Street:
City: State: Zip code:
Home Phone(Including Area Code):
Home E-mail Address:

Business Information:

Job Title:
Employer:

Business Address:

Street:
City: State: Zip code:
Business Phone(Including Area Code):
Business E-mail Address:

Spouse Information:

Spouse's Name:
Spouse's Employment:

Achievements/Awards/Other Notes of Interest

Back to Main Alumni Association Menu