Alumni Caucus for GLB Concerns
at Allegheny College


To join the Caucus, please fill out the form below and hit the submit button. Your information will be e-mailed to us and then added to the membership. If you have any questions, feel free to contact us at: glbcaucus@geocities.com


Name:

Partner's name:

Address:

City: State/Province: Postal Code:

E-mail:

Would you like to be included in an e-mail group which provides
updates on campus and Caucus events? Yes No

Webpage:

If we create links from the Caucus website, shall we include your webpage? Yes No

Home phone: Work phone: Fax:

Allegheny class: Major/minor:

Graduate work:
Degree:From/Year:
Degree:From/Year:

Occupation: Employer:

You can use my name for:

- a directory distributed to the caucus membership.
- Allegheny lesbigay students wanting career advise or city information.
- the Allegheny Alumni Office for mailing purposes only.
- the Caucus newsletter.
- In the newsletter, should we use your FULL name or FIRST name and last initial?

If you select either of the options below, that will negate any 'yes' answers from the above list.

- ONLY the Caucus steering committee.
- ONLY the Caucus steering committee and a member starting a local chapter in my city/area.

Comments, Questions, Ideas:


Back to Caucus Home Page

© 1999, Last updated: February 27, 1999

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