Department of Recreation and Athletics, Concordia University

Kindly do not use links, URLs (http://www.forexample.com) or email addresses (except where specified).

Name:	*
Degree:
Year:
Major:
Attended to:	Sir George Williams
	Loyola
	Concordia
Sport(s):
*
Years Played: (i.e. 1982, 1983)

Current Mailing Address:
No./Street/Apt.
Province/State
City
Postal/Zip Code
Email Address:	*
Phone:	*

Permanent Mailing Address
No./Street/Apt.
Province/State
City
Postal/Zip Code
Phone:

Employment Information:
Name of the Company:
Position:

Work Address:
No./Street/Apt.
Province/State
City
Postal/Zip Code
Phone:
ext.
fax:

	I would like to mentor a student athlete
	I would like to help with recruitment of student athletes
	I would like to volunteer with alumni activities

* required field

Share |