*First Name:        *Last Name 

Address:

City:      State:      Zip Code:

*Email Address:   

Dates attended UW-Fond du Lac:

Sports participated in at UW-Fond du Lac and dates:

Any accolades received for sports and/or academics:

Yes, I will be attending this event. Please indicate your participation below:

Please choose one Attending the almumni game and playing in the game
Attending the alumni game, but NOT playing in the game

Please indicate your t-shirt size if attending:

Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2XL

Sorry, I can not attend this event.