Alumni Information Form

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Dear MPA Alumni:

We very much want to keep in touch with you. We especially need current email addresses; since so much of correspondence is being done electronically.

So, please complete this form with your current information. You can also download a paper version of this form here and mail or fax it to us. If you have any difficulties completing this form, please contact us.

Thank you for taking the time to update us! We look forward to hearing from you!

Salutation
*First Name
*Last Name
Semester/Year graduated
*Address 1
*Address 2
*City
*State	Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
*Zip Code
Phone	. .
Cell Phone	. .
*Email address
Employer
Title/Position
Work Address
City
State	Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip Code
Work Phone	. . Ext.
Fax	. .
Work email address
We would appreciate you sharing any professional and personal news and activities (that you might also like to see included in an upcoming MPA program newsletter).

*Indicates a required field