Alumni Update Form

Alumni Update Form

Chemistry Alumni Update

To help the Department of Chemistry at Millersville University keep up to date with alumni, we request you submit the following information:

Name * First Last
Class Year *
MU Degree *
Post-Baccalaureate Degree *
Institution, year of graduation
If other degree, please indicate
Current Employer and Job Title *
How can we reach you?
Email *
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone - (###) - ### ####
Send news about yourself that you would like to share with us
Add my name to the mailing list for the Alumni News Letter Yes No
Interest in returning to campus to give a seminar Yes No
Interest in homecoming reception Yes No
Permission to share your information with University Advancement Yes No