Surveypoint

Q1

Full Name:

First Name

Q2

Full Name:

Last Name

Q3

Title:

Q4

Contact Number

Phone Number

Q5

Address

Street Address

Q6

Address

Street Address Line 2

Q7

Address

City

Q8

Address

State / Province

Q9

Address

Postal / Zip Code

Q10

Country:

Q11

E-mail:

Q12

School/College

Q13

Graduation Year:

Q14

Affiliation to Howard University

Q15

Occupation (if retired, choose your primary former career):

Q16

Are you a member of HUAA?

Q17

What is the best way to reach you?

Q18

Have you ever served in a student government position while attending Howard University?

Q19

If so, please note organization, position, and year

Q20

Have you ever served on the Howard University Board of Trustees?

Q21

If so, please note position, committees served, and years served

Q22

Please note Concerned Stakeholders committees upon which you would like to serve:

Q23

Concerned Stakeholder -Form Fill

Full Name:

Full Name:

Title:

Contact Number

Address

Address

Address

Address

Address

Country:

E-mail:

School/College

Graduation Year:

Affiliation to Howard University

Occupation (if retired, choose your primary former career):

Are you a member of HUAA?

What is the best way to reach you?

Have you ever served in a student government position while attending Howard University?

If so, please note organization, position, and year

Have you ever served on the Howard University Board of Trustees?

If so, please note position, committees served, and years served

Please note Concerned Stakeholders committees upon which you would like to serve:

Comment and Questions: