Alumni Association Executive Board Interest Response Form

The purpose of the Alumni Association Executive Board (AAEB) is to lead and represent alumni and current students in a mutually beneficial relationship with the College which results in a lifelong commitment of support.

The AAEB annually elects new members from among all candidates who have submitted an Interest Form. Board membership is diverse, and members are chosen based on criteria of class year, geographic area, affinity group associations, interests, and relationship with the College. Candidates remain in a pool for consideration over a three-year period.

Serving on the Lycoming College Alumni Executive Board is a prestigious role, and one that is greatly appreciated by the College. Such service also comes with certain expectations. Members are required to attend the Board's spring and fall meetings and to be active participants on one of the three committees of the Board. Attendance at Homecoming/Reunion Weekend and local alumni events is expected, as is participation in the College's Annual Fund to the degree that each member is able.

If you are interested in serving on the AAEB, please complete and submit the following form. Please contact the Office of Alumni Relations with any questions: alumni@lycoming.edu. Thank you for your interest!

Yes, I am interested in the opportunity to serve on Lycoming College's Alumni Association Executive Board.
No, I am not interested in the opportunity to serve on Lycoming College's Alumni Association Executive Board, but please update my file with the following information.

First Name Last Name
Maiden Name Nickname
Home Address
City, State & Zip Code
Home Phone Number
Email Address
Please indicate if this is a new address and phone number: Yes No

Occupation/ Title:
Retired: Yes No
Company/ Organization:
Business Address:
Business City, State & Zip
Business Phone:

Lycoming Degree: Class Year
Major(s):
Minor(s):
Campus Activities/Organizations, Greek Affiliation, Athletic Teams:

Degree(s) earned from other academic institution(s):

Military Service:

Please tell us about your family, if applicable.
Marital Status: Married Widow/ Widower Divorced Single
Spouse or Partner’s Name: Date of Marriage:
Spouse or Partner’s College: Class Year:
Children (names, ages, schools attended):

Personal interests, activities and hobbies

Clubs and professional organizations:

Honors, accomplishments and civic offices held:

Who are the Lycoming College friends and/or classmates that you keep in touch with?

What Lycoming College events do you regularly attend on or off campus?

Do you volunteer for Lycoming College currently? Yes No
If yes, how are you serving the College? (ex: Regional events, reunion committee, admissions recruitment, internships, career mentor, etc.)?

What professional skills and/or personal attributes do you feel would make you a strong contributing member of the AAEB?

Is there any other information that you would like to share with us?
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