Massachusetts Association SkillsUSA Alumni Information Form

First Name:

Last Name:

Nickname (if any)

Home Address:

City

State

Zip Code

Home Phone Number:

Mobile Number:

E-mail Address:

Name of High School:

Career Training Program:

Year of Graduation:

Name as you would like it to appear on your Wind Breaker:

What name do you prefer people to call you by? (Also to be used in scripts and introductions, ex: Fall State Leadership Conference)

Wind Breaker Size:

T-shirt Size:

Please know that the cost of a windbreaker is $45.00

Yearly Alumni dues are $5.00