St. Robert's School Alumni - Internet Request Form

Include ONLY the information that you want entered into the Internet Alumni database. All information will be entered into the WEB site and available to all persons accessing St. Robert's Internet WEB site (WWW.SAINTROBERTS.ORG). This information will not be sold by St. Robert's School.


St. Robert's School
345 Oak Avenue
San Bruno, CA 94066
Attn: St. Robert's Alumni Coordinator
- - or - - FAX the completed form to: (650) 583-1418

~ ~ ~ ~ ~ ~ ~ ~ ~ Alumni Information ~ ~ ~ ~ ~ ~ ~ ~ ~

First Name: _________________ Present Last Name: ______________________________

Last Name (name when graduated from St. Roberts): ______________________________

Street Address: ________________________ City, State: _____________________ , ____

Zip Code: _________ Year of graduation from St. Robert's (1964, etc): ________

Phone Number : ( ____ ) ____________ E-Mail Address: ___________________________

By signing this form, I authorize St. Robert's to add the above information to the St. Robert's Internet WEB site (WWW.SAINTROBERTS.ORG). I understand that this information will be available to any persons accessing this site. I understand that I may update this Internet Request Form via E-Mail; and I authorize St. Robert's to process such changes. I agree, that in the event of any use or misuse of the information provided on this form, St. Roberts Church, School, Staff and Agents will not be responsible or liable. I also certify that I am at least 18 years of age. Alumni below the age of 18 must have their parent or guardian sign this form.

( ____ ) _____________
Signature (Alumni or Parent/Guardian)
Phone # (Verification purposes only)
Upon receipt, this form will be verified by a telephone call to you from a member of your class. The information will be entered into the WEB site within one month of verification.