ALUMNI RELATIONS

Personal Information

Salutation Please Choose: Mr. Mrs. Ms. Miss Dr.

First Name Last Name

Address

City/State/Zip

E-Mail

All AAP communication is done by email. In order to participate in the AAP, you must have an active email address that you regularly check.

Home Phone

Ethnicity Gender Select One Male Female

Academic Information

Undergraduate School Please Choose: Adelbert Architecture Arts & Sciences Case Institute of Technology Cleveland College Education Engineering Flora Stone Mather Library Science Management Nursing Pharmacy Western Reserve College Graduation Date (MM/YY)

Undergraduate Major Undergraduate Degree

Undergraduate Minor

Undergraduate Activities/Organizations
List activities here.

I am currently involved in the following alumni activities:
List activities here.

Professional Experience

(Choose at least one)

Current Status: Student Employed Unemployed Retired

If Employed, Current Company

Company Address

City/State/Zip

Work Phone Industry

Job Function/Title Start Date (MM/YY)

Spouse

Is s/he a Case graduate? If so, Class Year, Degree(s) Major(s)
Enter spouse's degree information here.

Children's names and ages:
Please list your children's names and ages here.

I am interested in participating in the following Admission and Recruitment Opportunities

(Choose at least one.)

In Person Interview

Phone Interview

E-mail or telephone prospective students

E-mail or telephone admitted students

College Fair

I am also interested in being a volunteer in the area(s) of:

(Choose at least one.)

Career Assistance

Associations & Schools

Alumni Events

Other opportunities in support of students as they become available

At this time I am only interested in Admission & Recruitment.

Preferred Contact Method

(Choose one and be sure you have provided that information above.)

Email Home Address

Work Phone Home Phone

Work Address

Please enter any comments or questions here.

For more information, please contact Heidi McCormick at heidi.mccormick@case.edu.