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C250
Membership Information Update Form
Fill only the information changed. (Name, HomeEmail is required.)
Registration Day
Month(2 Digits) Day(2 Digits) Year
Name
Name:First Last
Membership Number(If you have):

Home Information
Address:
Telephone:
email:

Busienss Information
Business:
Position:
Address：
Telephone:
email:

Relationship to Columbia
School attended:
Years attended:
Degree Obtained:

Comments
Comments:

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