Name and Class

Full Name*

Maiden Name 

Graduation Year*

E-mail Address*

Home Address

Street Address 

City 

State/Province 

Postal Code 

Country 

Home Phone Number 

Cell Phone Number 

Family Information

Are you married?  -select- Yes No

If yes, spouse's full name 

Is your spouse a Bethel alum?  -select- Yes No

If yes, what is your spouse's college graduation year? 

Do you have any children?  -select- Yes No

Work Information

Employer Name 

Job Title 

Employer Address: City/State/Zip 

Employer Phone 

News

Can we post your updated information on the Social Work alumni webpage?* -select- Yes No

Would you like your family information included in the alumni section of Bethel Magazine?* -select- Yes No

Would you like your employment information included in the alumni section of Bethel Magazine?* -select- Yes No

Thanks for keeping in touch!

Amy White, MSW, LICSW

Corey Hobbins, MSW, LICSW

Sandra Traudt, MSW, LICSW

Julia Moen, MSW, LICSW

Kelly Brown, Administrative Assistant