Department of Recreation & Athletics - Concordia UniversityStinger Dome Rental Request

Varsity Alumni Registration Form

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

Hall of Fame Nomination