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Please submit your information below to help us keep our information up to date.

Last Name:
First Name:
Middle Name:
Maiden Name (if applicable):
Title:	Other:
Nickname:
Last 4 digits of Social Sec. #: (required for verification)
Address Line 1:
Address Line 2:
City
State
Zip:
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Spouse's Last Name:
Spouse's First Name:
Spouse's Title:	Other:
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4 Year Social Club
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Other campus activities: (SGA, honorary societies, Spectator, clubs, athletics, etc.)

Please use this additional area to share other information as you would like (additional degrees, birth of children, life notes, etc.) By completing this block, you are granting permission for MUW and the Office of Alumni Relations and to publish these notes, along with your name and class year.