YSU Alumni Update Form

Personal Information

Y-Number, if known

Found on your YCard or Student ID

Patron ID Number, if known (graduates prior to 2005)

First Name

Middle Name

Last Name

Maiden Name

Year of Graduation

Degree

Current Contact Address

Type of address

Permanent

Temporary

Approximate start date of residence

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

Country

City

Province

State

Zip Code

Have you moved since we last heard from you?

Yes

If unsure, hit 'yes' anyways and let us know your previous address so we can find you in our system.

Previous Contact Address

Approximate date of residence

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

Country

City

Province

State

Zip Code

E-mail Address

Phone Number

Enter only your 10 digit phone number without dashes or symbols.

LinkedIn URL

Spouse/Partner Name

Spouse/Partner Maiden Name

Spouse/Partner attended or graduated YSU

Yes

Business Information (Optional)

I am:

Currently Employed at the Organization Below

Retired

Place of Employment

Title

Address

City

State

Zip Code

Country

Employment Phone Number

Enter only the phone number without dashes or symbols.

Employment Email Address

Start Date

End Date

Information

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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