*Your Name (First, Middle Init, Last):

Maiden Name:

*Email:

*Phone:

*Mailing Address:

*City/State/Zip:

Permanent Address (if different):

City/State/Zip:

*First Year at PCA:

2014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963

*Last Year at PCA:

2014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963

*Last Grade Level Completed at PCA:

121110090807060504030201KPreK

How would you like to hear from us?

 E-Mail

 Direct Mail

How often would you like to hear from us?

AnnuallyQuarterlyMonthly

Would you like to have access to an online Alumni directory?

 Yes   No

Memories from PCA:

How has PCA influenced your life?

What schools have you attended since PCA?

Major/Minor:

Awards/Achievements:

Current Life Path/Goals:

Which of the following potential Alumni events would you attend?

(please select all that apply)

 Alumni Breakfast

 Informal Reunion at PCA

 Campus Tours

 Phonathon for Annual Fund

 Joint Sporting Event between PCA Alumni & PCA Seniors

 Luncheon at PCA for Alumni during December

 Faculty & Alumni Reception

 Alumni Board Member & Meetings

 PCA Golf Tournament

 Senior Sendoff Breakfast

 Mentoring Program for Current PCA Students

 Alumni Career Day

 Alumni Game/Trivia Night

 5 Year Reunion

 10 Year Reunion

  15+ Year Reunion

Would you be willing to serve on PCA’s Alumni Council?

 Yes   No

The purpose of the council is to play an active role in developing and maintaining effective communication with and by PCA Alumni

Would you consider giving back time, talent, or resources to PCA by:

(please select all that apply)

 Contributing to PCA's Annual Fund?

 Volunteering time and talent on a PCA alumni committee?

 Speaking about your profession to a small student assembly?

 Volunteering time as a Class Captain for your class year?

 Sponsoring a scholarship for a qualifying PCA student?

*May we use your comments for promotional purposes?

 Yes   No   Contact me first

*Would you consider being included on our Alumni Profile page?

 Yes   No

Do you have any photos to share with PCA and your fellow Alums?

We would love to see them!

Please forward to PCA at ajewell@pantego.com or post them on our Facebook page at http://www.facebook.com/pantego