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First
Name |
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Color
Code for fields:
- Blue
= Mandatory
- Red
= Optional, but see rule 3 on home page
- Black
= Optional, no consequences
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Last
Name |
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Maiden
Name |
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Desired
Username |
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Password
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Triad
Employee Number |
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Business
Email Address, or |
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Home
Email Address
Note: One email address is mandatory, the
second is optional
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Email
me when new Alumni register |
Yes
No |
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Home
Phone |
Area:
Number:
Entry
format: xxx-xxxx
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Office
Phone |
Area:
Number:
Entry
format: xxx-xxxx Ext xxx
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Cell
Phone |
Area:
Number:
Entry
format: xxx-xxxx
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Year
Hired at Triad |
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Year
Departed |
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Year
Rehired |
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Year
departed again |
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Division |
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Final
Position |
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Current
Employer |
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Current
Position |
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Employer
City |
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Employer
State |
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Current
Residence City |
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Current
Residence State |
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Marital
Status |
Married
Single |
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Spouse
Name |
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Children: |
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1.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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2.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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3.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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4.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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5.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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6.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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7.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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8.
Name:
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Birth
Date: Mo:
Day:
Year:
4
digits for year, change 19 to 20 if needed |
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Number
of Grandchildren: |
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Personal
event announcements |
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Upload Picture
(Recommend filesize smaller than 100k) |
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