Alumni Board Election Report

Instructions

Please list any corrections or updates where necessary. If you have any questions, please contact the Home Office at 816-891-9200.

Required fields are marked by *.

CORPORATION'S LEGAL INFORMATION:

Name

Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

OFFICERS AND DIRECTORS OF ALUMNI BOARD

ALUMNI PRESIDENT

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI VICE PRESIDENT

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI SECRETARY

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI TREASURER

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 1

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 2

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 3

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 4

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 5

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 6

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 7

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 8

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 9

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 10

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 11

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

ALUMNI DIRECTOR 12

Name

First Name

Middle Name

Last Name

Suffix

Pin # Graduation Year

Home Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Home Phone Number Cell Phone Number Email Address Occupation Employer

Business Address Street Address Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Business Phone

Phone

Extension

Spouse's Name

First Name

Middle Name

Last Name

Suffix

Alpha Gamma Rho

Alpha Gamma Rho

Alumni Board Election Report

Alumni Board Election Report

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