First Name:
Last Name:
Last Name when you attended the College (if different):
Address:
City:
State:
Zip Code:
Work Phone:
Home Phone:
Year of Graduation:
Degree Earned:
Major:
Marital Status:
Current employer:
Current position:
Household income range:
Were you the first member of your family to attend college?
Has any member of your immediate family attended college since you attended?
Are you working in an industry directly related to your field of study?
If no, what was the reason for the change?
What is the highest degree you have earned?
Field of study:
If this degree was not from Medgar, where did you earn it?
Did you attend another college prior to matriculating at Medgar Evers College?
Do you plan on continuing your formal education?
If yes, when?
Where?
Have you ever served in the military?
Please list your most significant accomplishments since you graduated from the College:
Do you serve on the boards of any corporate or nonprofit organizations?
If yes, which one (s)?

How would you describe your educational experience at Medgar Evers College?

What would you like to see the College do for its alumni?
Would you be interested in volunteering as a mentor to Medgar Evers College students?
Are you interested in volunteering at College/alumni events?

Please tell us about your family (spouse, children, grandchildren, etc.):

 
Comments/Suggestions: