Class of 1972 Survey
Name:
First Name
Maiden Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Seasonal home address if applicable:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Seasonal home duration:
Please indicate months throughout the year at this address
Primary phone number:
Please enter a valid phone number.
Email:
example@example.com
Hometown during college:
Include Town/City & State
Spouse/significant other name and occupation, if applicable:
Is spouse/significant other an alum of Potsdam?:
Yes
No
If yes, class year of spouse/significant other:
Did you meet while attending Potsdam?:
Yes
No
If not, where did you first meet?:
Children:
Grandchildren:
Are any of your children or grandchildren Potsdam alumni or students?:
Yes
No
If yes, please list:
Academic Experience
Potsdam major(s):
If you were an education major, did you student teach?:
Yes
No
Subject:
Student teaching location:
How did your Potsdam journey influence your career path and future?:
Professional Experience
List your work experiences and where the jobs were located:
How many times, if ever, did you change careers? Please explain:
List other professional experiences (coaching, performing, exhibits, publications, awards, etc.):
List any membership in professional or voluntary organizations, boards, etc.:
List any additional information that you would like to share with your fellow classmates:
If you are retired, when did you retire?:
What do you enjoy doing in your free time?:
Be sure to include a current photo:
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