Keeping in touch with Millfield

Please help us to keep our records up-to-date and easy to amend by filling in all or any parts of the on-line questionnaire below:

Required fields are marked with *

About You

Title*

First name(s)*

Surname*

Previous Name (if applicable)

Date of Birth*

Address Line 1*

Address Line 2

Town*

County

Postcode

Country

Home Telephone

Mobile Telephone

Email address

Partner's name

Partner OM?

Names and DOB of children

Are your children current Millfield students or Old Millfieldians?
(please give names/dates/House)

Education History

Millfield Prep School dates

House

Millfield dates

House

University/Further Education

Date(s)

Subject(s)

Qualifications/Degree

Since Millfield

Current occupation/position

Name of Employer

Professional Qualifications

Trustee Directorships

Would you be willing to give Careers advice?

Please give a short autobiographical note about what you have been doing since your previous questionnaire.

Please tick this box if you would rather not have the above autobiography published in the "OM News" section of "Chronicle"

Other OMs

Please give details of OMs known to you but who may not be in touch with the OM Society.

Name

Address

Name

Address

Name

Address

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