UVM Living/Learning Center

Alumni Information Form

Name:

Home Address:

E-Mail Address:

Are you planning to attend the L/L Alumni and Friends Wine and Cheese Reception on Friday, June 2 between 4:30 and 6:30 p.m.? Yes No Maybe

Number of additional guests you will be bringing with you: Adults Children

Who else would you like to see at the reception?

Personal or Professional Web Site URL:

Years Associated With Living/Learning: (e.g., 1980 - 1984)

Check all that apply to you:

Program Director	Professional Staff
Program Member	Graduate Student Staff
Resident Assistant	Work-Study Student
Hall Advisor	Friend of Living/Learning
Hall Government/Council

Please detail your affiliations with the Living/Learning Center. List any programs you belonged to or directed, and any other leadership roles (i.e., Resident Assistant, Center Council/Hall Government, etc.) or any jobs you have held. Feel free to use this space to share a story or write a comment that we can post to the "Virtual Memory Book" on the web!

May we publish this information on the L/L Alumni Web Site? Yes No

When Information is complete, please hit "Submit" button:

To reset form and clear all values, hit "Reset" button: