OMA&D Alumni Connect Form

Stay connected with the Office of Minority Affairs and Diversity. You can use this form to share your life experiences. The information you share with us will be posted on the Alumni Connections Page, and you may be featured in our next issue of E-news.

Note that personal information other than your name (e.g. your mailing address, phone number, and email) will not be made public.

Name & Contact Information

Former Name

First Name (required)

Last Name (required)

Email Address (required)

Address

City

State

Zip or Postal Code

Country

Phone Number

Cultural Affiliation

Degree Information

Undergraduate
Major(s): Year:

Graduate
Major(s): Year:

Professional
Major(s): Year:

OMA&D Services Used/Affiliation

(Select all that apply)


Other (specify):

 

Stay Connected

(Select all that apply)

Alumni Updates

Please let us know what's happening in your world. All alumni are encouraged to tell us about careers, families, awards, travel, or anything you would like to share with the OMA&D and alumni.

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