La Roche Alumni Directory

Alumni Directory Registration

Use the form below to register for the Alumni Directory.  Your submission will be reviewed by the Alumni Relations staff.  You will be notified via email when your account has been approved and ready to use.

Personal Information

May we publish your personal email address online? Yes  No
Password must be at least six characters in length.
Re-enter Password:
First Name:
Last Name:
Maiden Name:
Postal Code:
Please enter if NOT United States.
Home Telephone:
Mobile Telephone:
Year Graduated: 4 digits, Ex. 2010 not 10
La Roche Degree/Major:
Are you interested in being on the Alumni Recruitment Team? Yes  No     What's this?
May we include you in our online Alumni Directory? Yes  No

Business Information

Job Title:
Business Email:
May we publish your business email address online? Yes  No
Business Name:
Business Address:
Business City:
Business State:
Business Postal Code:
Business Telephone:
Business Fax:
Are you the owner and/or operator of this business?   Yes  No
If "Yes", would you like to be included in the Alumni Business Directory?   Yes  No
Business Category:
Business Description:

For the Alumni Business Directory
Please be brief
Business Web Address:
May we publish your Web address online? Yes  No

Leave this field empty