Linn State Technical College Alumni Association Annual Membership 

1. Enter your biographical information (*denotes required field):
    

   *First Name:
   *Last Name:
   Maiden Name:
   *Phone:
   *Street Address:
   *City:
   *State or Province:		*Zip Code		*Country
   *Email Address:
   Class of:	Choose One 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
   Program:

    

2. Enter your Spouse or Partner’s information:
    

   Spouse or Partner’s Full Name:
   Spouse or Partner Maiden Name:
   My spouse or partner is an alumnus/alumnae of LSTC:               Choose One Yes No
   Spouse or Partner’s Program:

    

3. Enter your employment information:
    

   Business Title:
   Business Name:
   Business Address:					City:
   State:		Zip:			Country:
   Business Phone:		Business Email:
   Preferred Address for contact:      Choose One Home Business