Alumni

Name*

First Middle Last

Maiden Name

Address*

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

Phone*

Email*

Can this be listed in the Alumni Newsletter?*

Yes
No

MCC

Years Attended (MCC)*

Program*

Year Graduated*

Degree / Certificate*

Undergraduate Transfer Institution

Year Graduated

Program / Degree

Graduate Institution

Graduate Transfer Institution

Year Graduated

Program / Degree

Employer

Employer Name

Employer Address

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

Position

Spouse

Spouse's Name

Did spouse attend MCC?

Yes
No

Year Graduated

Degree

Alumni Relationships

Were you a second or third generation MCC student, or are you part of a "MCC Family"? If so, please list your parent(s) and sibling(s), their current addresses and the years they attended MCC. Would you please share the link to this form with them? We would like to add your family to our mailing list. THANK YOU!

Family Information

Death Information

Please provide MCC with information regarding the death of an alum (name, date of death, and any additional information you can share).

Can we include this death notice in the next Alumni Newsletter?*

Yes
No

Would you or your employer be interested in hiring an MCC graduate if you were in need of an employee?*

Yes
No

Would you or your employer be interested in participating in a Career Fair held on the MCC campus?*

Yes
No

If you wish, include additional information (comments or suggestions about MCC, news about the years since you left MCC, special honors, etc.) and send with your Alumni Update.

MCC Alumni Information Staff

Phone: (641) 752-7106, Ext. 5747

Fax: (641) 752-8149

Email: Carol.Geil@iavalley.sites.flyinghippo.com

Carol Geil, Alumni Director & MCC Alumna

Liz Lacina, Office Associate & MCC Alumna

Name

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MCC Alumni Update

MCC

Undergraduate Transfer Institution

Graduate Institution

Employer

Spouse

Alumni Relationships