STAT: Students Today, Alumni Tomorrow

Join Now! | Join by Form | Membership Benefits

To join STAT, fill out and print this form and mail it along with your check to:

STAT
C/O SIUE Alumni Association
Campus Box 1031
Edwardsville, IL 62026-1031

You may also stop by the office on the first floor of Birger Hall to drop off your application.

1. Your Information

Last Name

First Name

Banner ID #

Maiden Name

Title Select title

Mr. Mrs. Ms. Miss. Dr.

Current Grade Level

Fresh Soph Junior Senior Grad

Expected Graduation Date

Major(s)

Previous SIUE Degree(s) and Graduate Date(s) (if applicable)

E-mail

T-Shirt Size

S M L XL XXL

3. Spouse Information

	Yes! My spouse/domestic partner is current student.
	Yes! My spouse/domestic partner is an alumna/us.

Last Name

First Name

Middle Name

Maiden Name

Title Select title

Mr. Mrs. Ms. Miss. Dr.

SIUE Current Grade Level

Banner ID #

SIUE Graduation Year(s)

SIUE Degree(s)

E-mail

4. Mailing Information

Address

City

State

Zip Code

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