SIUAA Digital Card Request

Digital Card Request
Please ensure you enter your preferred email address. This will be where the link with your digital card is sent. Your digital alumni card will be delivered within one week of submitting this form.

Thank you for your support of the SIU Alumni Association.
Name:

First NameMiddle NameLast NameSuffix (optional)
Former Name:
Maiden Name:
DOB:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email:
example@example.com
Graduation Year:
Please contact the SIU Alumni Association at (618) 453-2408 if you have any questions.
Submission Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Should be Empty: