Register Alumni Information

Please complete the following form with the most recent information about yourself:

* - Required Field

Graduation Year*:

First Name*:

Middle Name:

Last Name*:

Maiden Name: (if applicable)

Address:

City:

State/Province:

Zip/Postal Code:

Country*:

Home Phone:

E-mail Address*:

Occupation:

Employer Name:

Employer Address:

Employer Phone:

Marital Status: Single Married

Spouse's Name:

Is Spouse an IHS Graduate? Yes No

Spouse's Graduation Year:

Spouse's Maiden Name:

Verification Code: verification image, type it in the box

If you are interested in supporting the early stages of the Association through a donation, please send that donation to:

Independence High School Alumni Association
PO Box 346
Independence, IA 50644

Special Thanks