Alumni Email Form

< back to previous

Alumni Information Form

Submit the form to update your Alumni profile in the Siena Heights University database.

* Denotes required field

Current Home Address
	Street Address:

	City:

	State:

	Zip Code:

	Phone:*
	- -
	Email Address:*
	I would also like to receive the email newsletter.
	May we include you in the online e-mail directory? Yes No
	Personal Web Page:

	SHU Campus You Attended:

Business Information
	Occupation:

	Company Name:

	Is this a Matching Gift Company:Yes No Unsure
	Business Address


	City

	State:

	Country:

	Zip Code:

	Business Phone:
	- -
	Business E-mail Address:

	Business Fax:
	- -
	Business Web Page:

	I prefer to receive correspondence through my home or business address (Please chose one.)*
	Home Office

Education

Please indicate all higher education received after Siena Heights University.

Family

Spouse's First Name:

Spouse's Last Name:

Spouse's Middle Initial:

Is spouse a Siena graduate?

Yes No

Spouse's Degree/ Graduation Year if SHU graduate:

Degree: Graduation Year:

Spouse's name at graduation if SHU graduate?

Any news you would like to share?

May we include this information in the alumni magazine Reflections?

Yes No