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    Registration Information    Planted Tree

   

All required fields are marked with a *

*
 Yes! I want to be a permanent part of Queens College history.
          Here is my contribution and a order for a planted tree.

* First Name:    
M.I.:    
* Last Name:    
    
* Street Address:    
Apt:
* City:    
* State:    
* Zip:    
* Home Telephone:    
Business Telephone:
* Email Address:    

*(Please check one of the radio buttons)
     This is a surprise gift. DO NOT send acknowledgement letter.
      Please send notification of this gift to:

First Name:    
M.I.:    
Last Name:    
    
Street Address:    
Apt:
City:    
State:    
Zip:    

* Please type the information exactly as you would like it to appear.
Maximun 20 characters per line, including spaces.

  Sample
IN MEMORY OF (IN HONOR OF)
JOHN DOE
CLASS OF 1950
 

For additional tree, please type the information below.

This tree is a gift:
*(Please check one of the radio buttons)
 Alumni         Parent         Faculty/Staff         Friend

Please check the information above and verify that all is correct. Once you have done so, please click the Continue button below to enter your order., or click clear form to clear the form's contents.