Concerned Stakeholder Contact Form

Concerned Stakeholder Form

Please enter your information below so that we may keep you informed.
Full Name:

First NameLast Name
Title:
Contact Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country:
E-mail:
example@example.com
School/College
Graduation Year:
Affiliation to Howard University
Occupation (if retired, choose your primary former career):
Are you a member of HUAA?
What is the best way to reach you?
Have you ever served in a student government position while attending Howard University?
If so, please note organization, position, and year
Have you ever served on the Howard University Board of Trustees?
If so, please note position, committees served, and years served
Please note Concerned Stakeholders committees* upon which you would like to serve:
*Please see descriptions of all committees here.

**If you would like to join one of the Alumni Independence subcommittees, please use this form. Thank you!!
Comment and Questions:
Source
Should be Empty:

Concerned Stakeholder Form