Education

Join the Circle of Trust

Please fill out the form below to join the Circle of Trust or to update your information. Once you submit the form, you will receive an introductory packet that includes instructions. If you have previously registered and are updating your contact information, thank you for your continued commitment to our cause.

* indicates required field.

About you

I am...

Title *

First Name *

Last Name *

Name of University/High School *

Class of

Job Title (if staff or administrator)

Email Address *

Primary Telephone *( ) -

...at home

Home Address *

Home Address 2

City *

State *

Zip Code *

...at school

The address entered below will be the primary address The Gordie Foundation will use to send you information.

High School Students: If you are living at home while attending high school, please simply re-enter your home address below.

College/University/Boarding School Students: Most institutions provide mail service for students living on campus grounds. If you have a post office box, please enter that information below. If you live at an off-campus residence, please provide that address.

School/Shipping Address *

Mailbox/Unit number (if any)

City *

State *

Zip Code *

My COT Status

Check here if you are a current COT member and have graduated from college.

This semester, I will be...

If abroad, when will you return?

If you are a current COT member and have transferred schools, please list your previous school.

If you listed "other" above, please explain:

Additional Notes: