Alumni Data Input Form

DATA INPUT FORM

So that the Kids From Wisconsin can keep in touch with you, please fill out the following form. You do not have to fill out any data fields you do not want to enter. Of course, if you don't give us a way to contact you it'll defeat the purpose of this effort.

Thanks,

Hey PJ,

Please put my personal information in the private Kids Database.

This is my name I used while in the Kids From Wisconsin: . (ie. PJ Azzolina)

This is my current last name: . (ie. Azzolina-Dillard) (No, I don't go by that name, it's just an example.)

This is my current first name: . (ie. PJ)

My title is: . (ie. Mr., Ms., Mrs., Dr., Rev., Col., etc.)

My address (first line) is: . (ie. 43586 Wild Ginger Ter.)

My address (second line) is: . (ie. # 123)

My City is: . (ie. Lansdowne)

My State is: . (ie. VA) Please use the two letter State abbreviation.

My Zip Code is: . (ie. 20176-8439) Nine digits, with hyphen recommended but not required.

Country: . (ie. Germany) In case you live outside of the US.

My Home Phone is: . (ie. 414-222-2222) Please don't forget the area code. I don't care if you use brackets or not.

My Mobile Phone is: . (ie. 262-222-3333)

My Work Phone is: (ie. 703-222-4444)

My Alternate Phone is: . (ie. 262-222-5555) Free text area to explain what this number is: . (ie. "Sister's Phone")

I am a: . If you have multiple employee types, (ie. Alumnus and Staff), pick whichever one you prefer.

I was in the Kids from: to . PJ, what do I do if I have a split? "Once a Kid. Always a Kid." Pick the whole timeframe.

My email address is: . (ie. PJ@PJAzz.com)

My maiden name is: . (ie. Lovett)

I'd like to volunteer to help the Kids: Yes, No.

Comments:

Thanks for giving us your information. We will keep your data private and anyone trying to contact you will go through us first. After that you have the option to contact them, if you'd like.

"It's been a ball."

Sincerely,