Title:

Legal First Name:

Preferred First Name:

Middle Initial:

Last Name:

Maiden Name:

Waldorf Class Year, AA:

Waldorf Class Year, BA:

Home Address:

Home Address (cont):

City:

State:

Zip Code:

Country:

Home Phone:

Home E-mail:

Occupation:

Organization:

Work Phone:

Business E-mail:

Do you wish to have your address printed in the Waldorf Magazine?

Do you wish to receive the Waldorf alumni e-newsletter? If yes, you must provide us with an email address above.

If yes, send to e-mail address:

Comments or Misc. Information (children, marriage(s), honor(s) to be used for class letter and The Waldorf Magazine.

Do you or your spouse qualify for matching gifts from employer and/or Thrivent Financial?

Corporation Name:

Who qualifies for match: