Tell Us Your News Form - Clark College Foundation

First Name*

Last Name*

Maiden name if applicable

ATTENDANCE INFORMATION

Year(s) Attended (e.g., 1971 - 1973)*

Degree/ Certificate

I didn't graduate, but I attended during these years (e.g., 2001-2003)

Email*

Phone number with area code (cell)

Phone number with area code (land line)

Address

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

We may edit for brevity and correct grammar.

Send a photo

Drop files here or

Max. file size: 50 MB.

Name of club

Years in club

Title or position in club

Sport #1

Year(s) participated in sport #1

Sport #2

Year(s) in sport $2