To become a Corry Advocate…please submit the form below or contact us via the information below. You can email a picture if you like or stop at the Corry Hi-Ed office and we will take one for you if you would like to have one posted.
Corry Advocates c/o Corry Higher Education Council Yulonda Theuret 221 N Center St Corry, PA 16407 814-664-9405 ytheuret@corryhied.org
Corry Advocates c/o Corry Community Development Corp. Chris Schalles 1524 Enterprise Road Corry, PA 16407 814-664-3884 ccdc@velocity.net
All asterisked items are for in-house use only and will not be posted on the web. This information is voluntary. Fill in only the items that you want to share with us. We may use your mailing address to contact you at a later date.
Name:
* Address:
* City:
* State:
* Zip:
Daytime Phone:
Evening Phone:
Cell Phone:
Place of employment:
Title:
Fax:
E-mail:
Age group:
Please Choose... 18-25 26-35 36-50 51-65 65+
Children, grandchildren and ages:
Favorite thing about Corry:
How long have you lived in Corry?:
Favorite spot in Corry:
Favorite place to eat in Corry:
Other areas you have lived :
What college/universities have you attended:
List professional/social affiliations (include any board on which you serve):
List any hobbies/pastimes you enjoy:
* How did you hear about Corry Advocates?:
*Why do you want to be an Advocate?:
* Any special skills you can contribute to the Advocates (photography, writing, art, public speaking, etc.):