YSU Alumni Update Form

Personal Information

First Name *

Middle Name

Last Name *

Maiden Name

Year of Graduation *

Degree

Street Address including apartment and/or unit number (if applicable) *

City *

State

Zip Code *

Country *

E-mail Address *

Phone Number

Spouse/Partner Name

Spouse/Partner Maiden Name

Spouse/Partner attended or graduated YSU

Yes

Business Information

I am:

Currently Employed at the Organization Below

Retired from the Organization Below

Place of Employment

Title

Address

City

State

Zip Code

Country

Employment Phone Number

Employment Email Address

Please keep us informed when you have moved or changed employment.

Feel free to mail additional news for inclusion in alumni publications. Send your submissions via email to Heather Belgin.

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