Name: |
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Email Address: |
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Current Home Address: |
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Home City: |
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State: |
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Zip: |
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If this address is new or different from when you attended GSU, please provide past address:
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Address line 1: |
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Address line 2: |
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City: |
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State: |
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Zip: |
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What is your preferred phone number: |
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This phone is a: |
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How do you want us to communicate with you? |
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What events have you participated in at Governors State University since you graduated?
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What types of activities would you be interested in participating with GSU or at other venues?
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If you are interested in networking events in your field, what activity would interest you the most?
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What geographic area would you want the activity held (please be specific)?
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If you live outside the Chicagoland geographic area, are you interested in joining an alumni group in your area?
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Are you a Veteran?
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If Yes to above, What Branch of Service?
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What types of benefits should the Alumni Association offer its Premium members?
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Do you follow GSU on (check all that apply):
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Other social networking platforms (please specify):
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Do you follow the Alumni Association on any social networking platforms?
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What social networking strategy would you suggest: |
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Please provide your occupation:
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Employer name: |
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Job Title: |
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Address: |
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City: |
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State: |
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Zip: |
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If you are retired, please indicate where you were employed prior to retirement.
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Employer name: |
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Job Title: |
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Address: |
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City: |
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State: |
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Zip: |
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Are you interested in your organization being involved with GSU? |
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If yes above, how do you see your organization involved and who should we contact:
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Did you have a faculty or staff member that positively influenced in you?
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I would like information about (check all that apply)
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If “Other” please describe:
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Please provide any further comments you may have.
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Thank you for your input. Your time is greatly appreciated.
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