Alumni Information Update Form

This alumni update is being completed for:   PSU Alumni   Deceased Alumni  
Deceased Date (mm/dd/yyyy) 

Degree Information

Last (current) (required)
First (required)
Middle (required)
Maiden Name Preferred Name
Former Last Name(s)
Birthdate (verification purpose only - optional) mm/dd/yyyy

Name at time of Graduation
Class Year Fall Semester      Spring Semester
Degree Received
Major Department
Minor Received (if any)

Is spouse/partner a PSU Alumni? Yes      No
Spouse/Partner's Name at time of Graduation
Spouse/Partner's Class Year Fall Semester      Spring Semester
Spouse/Partner's Degree Received
Spouse/Partner's Major Department

Contact Information and Comments

Home Phone Home Fax
Personal Email
Home Street Address
Home City
Home State Home Zip
Please list any news about yourself or other PSU graduates such as promotions, recognitions, weddings, births, deaths, other degrees received (degree date, institution, degree earned), etc.
Enter any additional comments in the space below

Business Information

Job Title, Position or Occupation (indicate if retired)
Business Name
Business Phone Business Fax
Email (business)
Business Street Address
Business City
Business State Business Zip
Current Income (optional)
    Under $25,000     $45,001 to $55,000
    $25,001 to $35,000     $55,001 to $100,000
    $35,001 to $45,000     Over $100,000
There may be employment opportunities and/or internships available with this company. YES NO
Contact Person
Contact's Title/Department
Contact's Phone (if known)