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Your Information

Full First Name*

Preferred Name
(If different than your full first name)

Legal Last Name*

Former/Maiden Name

Augustana College Graduation Year*

Your Birthdate*
For matching to your Augustana record. This information will not appear with your Class Notes submission.

Email address*
For matching to your Augustana record. This information will not appear with your Class Notes submission.

Street Address*
For matching to your Augustana record. Your street address will not appear with your Class Notes submission.

Country

Street

City

Region

Postal Code

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By submitting this form, you consent to Augustana College publishing your name, grad year and Class Notes update on a public website. Your birthdate, email address and mailing address will not be published.

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