New Customer Registration Form

Southern Union Alumni Association
Full Name*

First NameLast Name
Maiden Name (if applicable)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
What is your best form of contact? *
What year(s) did you attend/graduate from SU?*
Degree of Program Studied*
Campus Attended*
Were you involved in any activities/extracurriculars on campus?:
Would you be interested in receiving occasional alumni newsletters and event updates?*

YesNoMaybe
Would you like to volunteer with the Alumni Association?*

YesNoMaybe
Would you be willing in speaking to current students about your career path and your experience at Southern Union?*

YesNoMaybe
Are you willing to be featured in alumni success stories?*

YesNoMaybe
How would you like to see the Southern Union Alumni Association utilized in your community?

Join Now! *

SU Alumni Association Membership Fee

$25.00 Quantity

Total

$0.00

Southern Union Alumni Association