2012 JSA Alumni Update

Complete this form and be listed in the 2012 JSA Alumni Directory!

First Name *

Last Name *

Email Address *

Address

Street

City

State

Zip

Phone Numbers

Home

Mobile

High School

School Name

Graduation Year

Undergraduate Education

School Name

Graduation Year

Current Employment

Employer Name

Occupation

JSA Involvement - Check all that apply

Chapter Member Yes

Chapter President Yes

Cabinet Member Yes

Elected Official Yes

Symposium/Institute Attendee Yes

Summer School Attendee Yes

Summer School Campus *

Summer School Year *

Your News and Updates

Tell us what you have been up to and we'll publish it in the class notes section of the Alumni Directory!

Privacy Controls

You decide what's published and what's kept only between you and JSA.

Choose No to publish the info in the Alumni Directory. Choose Yes to keep it for JSA internal use only.

Email Address Private? YesNo

Home Phone Private? YesNo

Mobile Phone Private? YesNo

Address Private? YesNo