St. Augustine Church & Catholic Student Center
Alpha Community Dinner & Serenade RSVP Form
(and contact update)

I (we) will be attending the Dinner

# of people in my party:

I (we) will be participating in the Serenade.

I can assist with the car pool to Serenade.

# of people that can ride in my car (besides me):

I can play an instrument for Serenade:

I would like to purchase (#) Commemorative Alpha 30th Anniversary T-shirt(s)
T-shirt Size(s):

Last Name   First Name    E-mail address

Candidate Alpha Semester/Year: Graduation Year/Degree:

Did you ever serve on Alpha Team: No  Yes, Semester/Year(s):

Did you ever serve as a Team Leader: No Yes, Semester/Year(s):

Address City State   Zip

Home Phone    Cell Phone   Work Phone

D.O.B.  (mm/dd/yyyy)  Ethnicity                 

Marital Status Single Married Widowed Separated Divorced    Address Preference None Mr. and Mrs. Ms. Mr. Dr. and Mrs. Mr. and Dr. Drs.    

Occupation    Employer  

What were you involved in at St. Augustine?

Spouse Information:

Last Name   First Name    E-mail address

Candidate Alpha Semester/Year: College/Graduation Year

Did you ever serve on Alpha Team: No  Yes, Semester/Year(s):

Did you ever serve as a Team Leader: No Yes, Semester/Year(s):

Cell Phone   Work Phone

D.O.B.  (mm/dd/yyyy)  Ethnicity                 

Address Preference None Mr. and Mrs. Ms. Mr. Dr. and Mrs. Mr. and Dr. Drs.     Occupation    Employer  

Was your spouse also involved at St. Augustine? If so, in what way?

Children:

Child 1

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 2

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 3

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 4

Name        Sex Male Female     DOB (mm/dd/yyyy)

Child 5

Name        Sex Male Female     DOB (mm/dd/yyyy)

We would like to receive the Take and Read Newsletter:

By Mail

By E-mail

I would like to learn how I can contribute to the Student Center:

Feel free to share some news with us: