Development and Alumni

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Title (Mr Ms Miss Mrs etc.)

Surname/Family name

First name(s)

Previous surname, if changed

Date of Birth (DD/MM/YY)

Gender:
Male Female

Correspondence address

Postcode

Home Tel. No (including STD code).

Mobile Tel. No

Email Address*requiredformat

We would like to know where you are currently working

Job Title

Employers Name

Employers Address

Postcode

Work Tel

Work Email

Year of Graduation

Qualification

Subject

Do you have any family members that are also UEL graduates?

Name

Year of Graduation

Subject

What sort of events and activities would you be interested in attending? (Please tick all that apply)

Lectures

Campus Tours

Cultural Events

Business Networking

Music events

Reunions

Sporting events

Other (please specify)

In what ways would you be interested in helping the Alumni Network? (Please tick all that apply)

Forming a UEL alumni group in your area

Helping to organise a reunion

Participating in fundraising activities

Giving careers advice to current students/recent graduates

Do you have a story?
Yes No

Would you be willing for your story to be used as an alumni case study for use in UEL promotional materials?
Yes No

Please give details of any comments/suggestions you may have.

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