Alumni Update
PERSONAL INFORMATION
Name: __________________ ___ ___________________ ___________________
First MI Last Maiden
Nickname: ______________ Mr. Mrs. Miss Dr. Other: _______________
Suffix: Jr. Sr. Ph.D. J.D. Other: _________________
Date of Birth: ______ / ______ / ______ (mm/dd/yyyy)
Gender: Female Male Marital Status:
SPOUSE: Name: _______________________ Occupation: _________________________
Is your spouse a UVI Alum? Yes No
Mailing Address: _____________________ ___________________ , ______ __________
Street/P. O. Box City State Zip Code
Cell Phone ( )
___________ Phone ( )
____________ Email______________________
CHILDREN: Name _____________________ Age ______ UVI Alum? Yes No
Name _____________________ Age ______ UVI Alum? Yes No
Name _____________________ Age ______ UVI Alum? Yes No
Name _____________________ Age ______ UVI Alum? Yes No
COMMUNICATION PREFERENCE: My preferred method of communication is:
Email Postal Mail
DEGREE INFORMATION
Graduation Year: ______ Major: ____________________ Minor: ____________________
Graduation Year: ______ Major: ____________________ Minor: ____________________
Graduation Year: ______ Major: ____________________ Minor: ____________________