Office of Alumni Relations Update Form

DO WE KNOW EVERYTHING ABOUT YOU?

Please complete the following form so that the Office of Alumni Relations has updated information in our alumni files. Often we have some of the information, but in order to have as accurate a record as possible, we ask that you take a few minutes to complete the following form. The information gathered here will help our office as we plan events and help with ways to communicate with all of our alumni.

PERSONAL
First Name:
Last Name:		Maiden Name:
Class Year:		Major:
Home Address:
City:		State:
Country:		Zip:
Home Telephone:		Cell Phone:
Home E-mail:		Home Fax:
Occupation/Business Title:
Employer:		Business Address:
Business City:		Business State:
Business Zip:		Business Telephone:
Business E-mail:		Business Fax:
Preferred Title:	Mr Mrs Ms Miss Dr Esq Other
If you selected 'other' for your preferred title, please describe:
Advanced degrees/institutions:
Memberships and leadership roles in community and professional organizations:
FAMILY

Spouse’s Name:
Spouse’s Occupation/Business Title:
Spouse’s Employer:
Spouse’s Degree(s)/Institutions:
Spouse’s memberships and leadership roles in community and professional organizations:
Children (Please list name, dob, sex, school/college and grade/year):
YOUR YEARS AT WAGNER
Did you commute or live in the residence halls? If you resided, which residence hall(s)?:
What was your hometown before attending Wagner?:
From which high school did you graduate?:
Did you receive a scholarship while at Wagner? If so, in what area?:
Who was your favorite professor?:
In which clubs, sports, or activities did you participate in?:
Please list parents, children or relatives who have attended Wagner (Names, Relationship, Class Year):
Comments/Interests: