UB Alumni

Personal Information

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First Name:

Last Name:

Address:

City:

State:

Zip:

Home Phone Number:

Cell Phone Number:

Email Address (use the one you check the most):

Education

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Current Status:

Enrolled in College -1st year Enrolled in College - 2nd year Enrolled in College - 3rd year Enrolled in College - 4th year Enrolled in College -5th year Enrolled in College - 6th + year Graduated with an Associate's Degree Graduated with a Bachelor's Degree Graduated with a Graduate Degree Not Enrolled in College Working FT Working PT Enrolled in the Military Other

College Currently Attending or Graduated From:

 

If you are still attending college, please fill in the following information:

College Address:

City:

State:

Zip Code:

Year you graduated or expect to graduate from college:

Major:

Achievements, Awards, and Scholarships

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Are you working in your career field that you went to college for?:

(if so, please describe your title and place of employment.)

Have you gotten any recent promotions?:

(if so, what promotions have you earned?)

Summary

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May we use the information provided to post on our website and in promotional materials? :

Yes No

(We would not post your personal information like your phone number or address-only your testimonials about how much UB has helped you, what college you are attending, scholarships/awards received, what your major is, etc.)

How has UB helped you?:

What you wish you would have done differently?:

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