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Information Update and/or Submit News Form

We'd love to keep in touch with you! Please use this form to help us keep our records up-to-date. Update your address, let us know that you've just gotten married or welcomed a new baby into your family, or tell us about your new job. Information submitted may be included in a future issue of the Bethel Focus or Heart and Mind magazine.

* Indicates required form fields. Your form cannot be processed until these fields are filled in.

Tell Us Who You Are

Prefix:

First name:*

Middle initial:

Last name while attending Bethel:*

Last name now, if applicable:

School(s) you attended:*

Graduation year:

Preferred class year:

( The class year you prefer to be invited to for reunions )

Marital Status:

Single

Married

Divorced

Tell Us Where You Live

Street address:

City:

State:

Postal code:

Country:

Phone:

Phone Type:

Home

Cell

If the above address is new, please complete the the following information for cross reference purposes:

Former address:

Former city:

Former state:

Former postal code:

Former country:

Former phone:

Current email address:*

Church Information

Name of church you are attending:

Denomination:

Family Information

Spouse:

Spouse's maiden name:

School spouse attended:

If spouse is a Bethel Alum, enter class year:

Spouse's preferred class year:

( The class year you prefer to be invited to for reunions. )

Email address:

Date married:

Check this box if you have had a recent marriage and would like a wedding announcement to be included in the alumni news section of Focus or Heart & Mind.

Wedding Announcement

Yes

Are there any other wedding details you would like included?

Have you had a child or children? If so, is this a:

Birth

Adoption

1. Child's name:

Date of birth

2. Child's name:

Date of birth

3. Child's name:

Date of birth

4. Child's name:

Date of birth

5. Child's name:

Date of birth

Check this box if you would like an announcement of the birth or adoption included in the alumni section of Focus or Heart & Mind.

Yes

What would you like us to print in the magazine?

Do you have a death to report? If so, please tell us:

Deceased person's name:

If deceased person is an alumnus/alumna, enter class year:

School deceased attended:

	Traditional undergraduate (College of Arts & Sciences)
	Adult degree completion (College of Adult & Professional Studies)
	Graduate degree (Graduate School)
	Seminary (Bethel Seminary)

If not an alum, his/her relationship to Bethel:

Date of death:

Tell Us Where You Work

Job title/position:

Employer:

Job/position start date:

Business street address:

Business city:

Business state:

Business postal code:

Business phone number:

Check this box if you would like to have your work information (position & employer) added to the Focus or Heart & Mind.

Work Information

Yes

Further news to submit for the Focus or Heart & Mind

Are you interested in volunteer opportunities at Bethel?

Volunteer Opportunities

Yes