Please provide the following contact information. Information is blue is required.
First Name Last Name Employer Street Address Address (cont.) City Parish/State Postal Code/Zip Country Work Phone Home Phone Cell E-mail URL House: N/A Butterfield (green) Darrell (blue) Saltus (red) Watlington (yellow) Year you left Saltus: Graduate or Form when left Does your company have a Matching Gifts programme? Yes No Does your company provide work/study opportunities? Yes No Do you receive the Saltus newspaper? Yes No Would you like to see more space devoted to alumni news? Yes No N/A Are you involved in any way in the life of the School? Yes No Would like to Do you have children at Saltus? Yes No If yes, how many? N/A 1 2 3 4 5 Do you volunteer at the School? Yes No Would like to Do you donate raffle prizes? Yes No Would like to Have you ever supported the Annual Fund? Yes No Would like to Would you like to participate in the Golf Tournament? Yes No Would like to Do you attend any functions at Saltus (e.g., plays, concerts)? Yes No Would like to If yes, please list: Are you encouraged to come back and do you feel welcomed at the school? Yes No Would you like to help organize alumni meetings and events? Yes No Please add any other comment that you feel may be of use:
Please add any other comment that you feel may be of use: