EmailMe Form - Share your life changes with us!

Prefix

Name *

First Last

Maiden Name

Class Year *

Birthday *

MM / DD / YYYY

Email *

Cell Phone Number

### - ### - ####

Phone Number

### - ### - ####

International Phone (if applicable)

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Professional Information

Occupation/Job Title

Employer

Is this a recent job change you would like to announce in Wartburg Magazine?

Yes

Do you interact with K-12 youth with your job or as a volunteer?

Yes

Business Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Business Phone Number

### - ### - ####

Advanced Degree Information

Post-Graduate Degree (if applicable)

Post-Graduate Institution

Program of Study

Post-Graduate Degree Grad Year (or when anticipated)

Is this a recent degree you would like to announce in Wartburg Magazine?

Yes

Personal Information

Church/Congregation

New child/children added to your family?

Update my record

Update record & announce in Wartburg Magazine

Please include names & birthdates (MM/DD/YYYY) of all your children:

Name of new child's other parent for magazine & grad year if Wartburg alum:

Do you have a change in your marital status?

Divorce (update my record)

Widowed (update my record)

New marriage (update my record)

New marriage (update record & announce in Wartburg Magazine)

Spouse/partner name & Date/Year of wedding (plus grad year if an alum)

Magazine Update

Include significant professional and/or personal news to share in Wartburg Magazine (to announce a new child or marriage, see fields above)

Share a photo