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 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 Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone 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

Add my name to the mailing list for the Alumni News Letter Yes No
Interest in returning to campus to give a seminar

Interest in returning to campus to give a seminar Yes No
Interest in homecoming reception

Interest in homecoming reception Yes No
Permission to share your information with University Advancement

Permission to share your information with University Advancement Yes No

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