YSU Alumni Update Form

Personal Information

Y-Number, if known

Found on your YCard or Student ID

First Name *

Middle Name

Last Name *

Maiden Name

Year of Graduation *

Degree

Current Contact Address

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

Country *

City *

State

Zip Code *

Have you moved since we last heard from you?

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

Yes

Previous Contact Address

Approximate date of residence

Year

Month

Day

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

Year

Month

Day

End Date

Year

Month

Day

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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