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Alumni

Update Your Information

Welcome to our online way of keeping connected!

Update your address, let us know of a name change or new phone number now. You do not need to fill out this form if you are joining the Alumni Association today or if you are renewing your membership.

Alumni Information Form

1. Privacy Information(Please check one)

	Yes! I want my e-mail address to be included in the Alumni Online Directory listed on the SIUE Alumni website.
	Yes! I would like to receive occasional emails announcing new benefits and events.
	Please update my information with the alumni office only. I do not want my name and e-mail address to appear on the Alumni Online Directory.

2. Your Information

Last Name

First Name

Middle Name

Maiden Name

Title Select title

Mr. Mrs. Ms. Miss. Dr.

SIUE Class Year(s)

SIUE Degree(s)

E-mail

Home URL

3. Spouse Information

Yes! My spouse is an alumna/us.

Last Name

First Name

Middle Name

Maiden Name

Title Select title

Mr. Mrs. Ms. Miss. Dr.

SIUE Class Year(s)

SIUE Degree(s)

E-mail

Home URL

4. Mailing Information

Address

City

State

Country

Zip Code

Home Telephone

5. Work Information

Job Title

Company Name

Address

City

State

Zip Code

Work Phone

Fax

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