CONTACT INFORMATION:

Last Name:      Maiden Name:

First Name and MI:      Date of Birth:

Current Address:

City:      State:      Zip:

Phone (please include area code):

Email:

To what address should we send mail?
Current Address (above)      Parents' Address

If you chose "Parents' Address," please supply the following:   

Parent(s) Name(s):

Parent(s) Address:

City:      State:      Zip:

Phone (please include area code):

Email:

ALUM DIRECTORY:
LCS is planning to create an online, password-protected alum directory on our web site. May we include your name and email address in this directory?
Yes      No

EDUCATION AFTER LCS:

High School Attended:

Year of Graduation:

College Attended:

Year of Graduation:      Degree:

Major/Minor:  

Other Post Secondary Institutions Attended:

Year of Graduation:      Degree:

Major/Minor:  

EMPLOYMENT:

Current Employer:

Profession:  

Title:

FAMILY INFORMATION:

Spouse/Partner's Name:

Number of Children:

Children's Names and Ages:

WHAT'S NEW?
Please tell us what you are doing now and any news you'd like to share.

ANYTHING ELSE?
Please tell us anything else you think would be helpful for us to know. Also, if you
know of address changes for siblings or other alums, please list them. Thank You!

DONATION?
If you would like to make a pledge or donation to Lake Country School at this time, please fill out the following information. Your gift is fully tax deductible. Otherwise, please scroll to the bottom of the page to submit your information.

I would like to make a gift of $ to Lake Country School.

I would like my/our gift to be directed to the:

Annual Fund (general donation)     Endowment Fund

Other (please specify):

Gift payment plan:

I will mail a check for the full amount

I will pay the full amount using a PayPal account

I will pay the full amount using a credit card via PayPal

I will pay the full amount using a credit card; please call me for credit card information

I will make payments of $ quarterly     monthly    

other:

I will direct United Way donations to Lake Country

I will transfer appreciated securities (click here for transfer instructions)

My employer will match match my/our gift.

Please make this gift   in honor of   in memory of:

Questions? Call Mary Vrabel or Angela Mullin at 612-827-3707 or send email to mvrabel@lakecountryschool.org