Giving to Regis

Please use this form to update your personal information with Regis University. All information is kept strictly confidential. All fields marked with an asterisk (*) are required.

This form may also be used to submit class notes (for yourself) for the Regis University Magazine. Contact information will never be published in the magazine’s class notes unless explicitly requested (e.g. your email address). Any information submitted for class notes will also be verified for authenticity and accuracy. Regis reserves the right to edit class notes for length, content and style.

Thank you for keeping us up to date!

Prefix:
First Name: *
Last Name: *
Maiden Name:
Address: *

City: *
State: *
Country: *
Zip Code: *
Home Phone: *
Home Fax:
Home Email: *
Birthdate (for verification of identity): *
Employer: *
Job Title: *
Marital Status:	Single Married
Spouse's Full Name:

Class Notes for Regis University Magazine

Does Regis have your permission to publish Class Notes information in our Magazine?
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Work Information
Business Address:
City:
State:
Country:
Zip Code:
Business Phone:
Business Fax:
Business Email:
Type of Business:

Education
Class Year:*
School:*	Regis College College for Professional Studies/RECEP Ruekert-Hartman College for Health Professions Loretto Heights College Other
Degree:
Major:
Graduate Institution:
Graduate Degree:
Graduate Major:
Spouse's Educational Institution:
Spouse's Degree:
Spouse's Major:
Spouse's Graduate Institution:
Spouse's Graduate Degree:
Spouse's Graduate Major:

Children
Full Name:
Date of Birth:
	Male Female

Full Name:
Date of Birth:
	Male Female

Full Name:
Date of Birth:
	Male Female

Full Name:
Date of Birth:
	Male Female

Full Name:
Date of Birth:
	Male Female

If you have questions, contact Ruth Franta, Director of University Relations Services, at 303-458-4253 or rfranta@regis.edu.

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Class Notes for Regis University Magazine

Work Information

Education

Children