| Beaver Dam Open House Registration |
| *First name: |
|
| *Last name: |
|
| *Address: |
|
| *City: |
|
| *State/province: |
|
| *ZIP code: |
|
| *E-mail: |
|
| *Phone number: |
|
| *High school: |
|
| *Graduation year: |
|
| Major: |
|
| Sports: |
|
| *Total number attending: |
|
| Is any guest joining you at the event an alumnus or alumna of St. Norbert? |
Yes No |
If yes, please provide name(s), graduating year(s) and relation to student:
|
|
| |