Name: Email:

Spouse Name:

Address:

City: State: Zip:

Phone:

Current Occupation:

Attended as a:

Camper     Year(s):

Counselor     Year(s):

Please share with us any news about yourself or your family:

Please share any special memories of Camp:

What five words best describe your experience at the University Settlement Beacon Summer Camp?:

Would you like to help with the planning of the University Settlement Beacon Camp Alumni Association? If so, how should we contact you? Yes No Email Phone

May we share your contact information with fellow alumni? Email Address Phone