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We want to hear from you!

Stay Connected: Alumni Information Form



We want to hear from you! Please complete the form below to inform us of a name change, new phone number or address, marriage, birth, or new job/promotion. We look forward to learning about you.


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
Mr. Miss.
Mrs. Dr.
Ms.

SIUE Class Year(s)


SIUE Degree(s)/Major(s)


E-mail


3. Spouse Information

Yes! My spouse is an alumna/us.

Last Name

First Name

Middle Name

Maiden Name
Mr. Miss.
Mrs. Dr.
Ms.

SIUE Class Year(s)


SIUE Degree(s)/Major(s)


E-mail


4. Mailing Address


Address

City

State

Country


Zip Code


Home Telephone

Cell Phone

5. Business Information


Job Title


Company Name


Address

City

State

Zip Code

Work Telephone

6. Tell us your news



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