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Alumni Registration Form

We can best serve you, our alumni, if we have current information about you. Please fill out and submit the following form. We would like to establish a searchable database but you must give us permission to post your personal information. Otherwise it will be kept confidential. Thank you all in advance for your help. We welcome all of your comments and suggestions.

Basic Information

First Name:
Last Name:
Maiden Name:
Class Year:
Advisor:
Degree(s) Obtained at Clemson (degree and date):
Degree(s) Obtained Elsewhere (degree,date and institution):


Contact Information

E-mail Address:

Home Address

Address 1:
Address 2:
City:
State:
ZIP:
Country:
Phone:

Business Address

Title:
Company:
Address 1:
Address 2:
City:
State:
ZIP:
Country:
Phone:
FAX:


Displaying Your Information and Contacting You

***May we make this information available on our website?
Yes   No

Would you be interested in making a financial contribution to the Department?
Yes   No
If yes, how may we contact you ?

Please enter any comments in the space provided below:
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