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Have you moved recently? Have you changed jobs? Please help keep us up to-date with your information so that we can keep you connected to Governors State University.

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Personal Information 
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* First Name: Middle Name:
   
 
* Last Name: * Name used while attending GSU:
   
 
Preferred Title: Relationship Status:
   
 
* Birthdate: (mm/dd/yyyy)
/ /  
 
* Street Address 1: Street Address 2:
   
 
* City:  
 
* State:  
 
* Zip Code: Country:
   
 
*       * Personal Email Address:
   
 
Business/Employer Information
 
Business Name: Business Title:
   
 
Street Address 1: Street Address 2:
   
 
City:
 
 
State:
 
 
Zip Code: Country:
   
 
Business Phone: Business Email Address:
   
 
Contact Preferences
 
To which address would you like mail sent?
       
 
To which e-mail address would you like e-mail sent?
       
 
Would you like more information on membership in the Governors State University Alumni Association?