Alumni & Friends Registration Form
Life brings many changes, but that's no reason to lose contact. We like to keep in touch with our Hilltop family, wherever their journey takes them. Let us know what's been going on in your life, and help us know how to reach out to you.
I am (select all that apply)
An Alumnus
A Donor
Current Staff/Faculty
Former Staff/Faculty
The Spouse/Partner of the Above
Name
*
First Name
Middle Name
Last Name
Previous first or last name(s) used
Did you attend High School on campus (CUC High School or PAA)?
Yes
No
Last year you attended High School?
Please Select
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Did you attend College/University on campus?
Yes
No
Last year you attended College/University?
Please Select
2025
2024
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2020
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Current Primary Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Primary Phone Number*
*
This number is a...
*
Land Line
Cell Phone
Alternate Phone Number*
This number is a...
Land Line
Cell Phone
Current Primary Email Address
*
example@example.com
Alternate Email Address
example@example.com
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Spouse/Partner Information
My Spouse/Partner is (select all that apply)
An Alumnus
A Donor
Current Staff/Faculty
Former Staff/Faculty
Unaffiliated
Deceased
If you selected deceased, in what year did your Spouse/Partner pass away?
Please Select
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
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1993
1992
1991
1990
1989
1988
1987
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1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
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1973
1972
1971
1970
1969
1968
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1932
1931
1930
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1928
1927
1926
1925
Name
First Name
Middle Name
Last Name
Did you attend High School on campus (CUC High School or PAA)?
Yes
No
Last year they attended High School?
Please Select
Did you attend College/University on campus?
Yes
No
Last year they attended College/University?
Please Select
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
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1933
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1928
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1925
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Use Previously Entered Address
Yes
Current Primary Phone Number
Please enter a valid phone number.
This number is a...
Land Line
Cell Phone
Alternate Phone Number
Please enter a valid phone number.
This number is a...
Land Line
Cell Phone
Current Primary Email Address
example@example.com
Alternate Email Address
example@example.com
Back
Next
Life Events
(500 characters max)
We want to feature you in the Burman University magazine. If you would like to be featured, please upload a current photo and use the area below to provide information of any recent major life events, such as weddings, new family additions, retirements, etc.
*
Yes, I would like to be featured.
No, I don't want to be featured.
Additional Information
0/500
Please indicate if you would like to receive lettermail and/or email from Burman University.
Lettermail*
*
Please Select
Yes
No
Email*
*
Please Select
Yes
No
Thank you for helping us keep in touch!
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