First Name

Middle Initial/Name

Last Name

Maiden Name

Address Line 1

Address Line 2

City

State

Best phone number

Phone Type

Best Email Address

Employer

Position

Prior Board Experience (Type of Board, Position(s) held, Years)

List your volunteer roles in the community.

Education

Dates at Graceland

Degree

Major

Campus Leadership Roles

Other Degrees Earned

Volunteer Interest

Please indicate which committee work is of most interest to you (check all that apply).

Alumni Engagement

Please share anything else you’d like us to know about you or your interest in volunteering to help with Alumni Board efforts.