My name is (fill in)
I prefer to be called (fill in nickname or prefered
name):
Year At LeMoyne (click on one)
I expect to graduate in of
My Major field of study is
I am also pursuing a Minor in (fill in or leave blank):
My academic advisor is (fill in):
My local address is:
My local telephone # is
My permanent address & telephone number is (if
different from local address)
The high school I attended was: