Class of  

First Name  

Last Name  

Maiden Name   

Employer    

Occupation    

Position   

Children?    yes      no

If yes, please list their names and ages below.

Do your children attend Liberty?           yes      no

Spouse's Name   

Spouse's Employer 

Is spouse an Alumnus of LCS?               yes      no

If yes, class of:  

Mailing Address      

City    

State                       Zip    

Home Phone     

E-mail      

How many years did you attend LCS?    

Education/Major/Degree

Church Attending     

Areas of Ministry

What should LCS be doing for our Alumni?

Would you like to receive e-mail updates from Liberty?      yes      no

Would you like to receive Liberty's newsletter via mail?     yes      no

Would be interested in an Alumni Association for LCS?      yes      no

Would be interested in serving on the LCS Alumni Association?  yes      no

If yes, in what capacity?

Would you be interested in an Alumni business directory?      yes      no

Can we share your name, city in which you live,  e-mail address, and years and grades you attended Liberty with others on our Alumni website?     

yes      no

If not, please let us know what you would like us to share or any other additional information you might want to share with others in the box below.

Additional Comments