Congressional Award: Join the Alumni Association!

Youth • Advisors • Alumni • Partners • Sponsors • Congress

Gold Medal Alumni Association Online Registration Form

First Name*
Last Name*
Date of Birth*	mm/dd/yyyy
Gender	Male Female
Address*
Address 2
City*
State*
Zip*
Phone*
Email*
Year Gold Medal Earned*
Current Employer (optional)
Position
Work Address
Work City
Work State
Zip
Work Phone
Work Email
How do you prefer to be contacted?	Work Home None
College/University (optional)
Degree Earned:
Major
Graduation Year


Thank you for registering with the Congressional Award Gold Medal Alumni Association!

“It starts with a dream and a goal, and can only happen if you go out and give it a try.”
John Rasmussen
Hutchinson, MN