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Prefix
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First name
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___________________________
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Current surname
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___________________________
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Former surname
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___________________________
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Street Address
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___________________________
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City
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__________________
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Province/State
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____________
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Country
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Postal Code
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____________
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Telephone
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_________________
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Fax
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_________________
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E-mail
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___________________________
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Alumni
Banter
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______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
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Mail your completed
form to
Alumni
Affairs Coordinator
c/o Jo-Anne Jarvis-Jordan
P.O. Box 550
Truro NS
B2N 5E3
or Fax to 902-897-9399.
or via
telephone to 902-893-6721.
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