Please Wait...

Alumni Contact Information -Form Fill

Section One
Q1

Graduation's Date

Day
Q2

Graduation's Date

Month
Q3

Graduation's Date

Year
Q4

Classmate Name

First Name
Q5

Classmate Name

Last Name
Q6

E-mail
Q7

Alternate E-mail
Q8

Address

Street Address
Q9

Address

Street Address Line 2
Q10

Address

City
Q11

Address

State / Province
Q12

Address

Postal / Zip Code
Q13

Address

Country
Q14

Phone Number

Phone Number
Q15

Designation/Profession

Major Field
Q16

Post-graduate Degree
Q17

Research/Teaching Area
Q18

Please tell us of your achievements, hobbies, travel, vivid memories of your time at UofK Faculty of Science , ambitions, and any other information you would like to share with former classmates & faculty members.
Q19

I give my permission to the Reunion Committee of UofK Faculty of Science Class of 1985 to include the above information in the Class Directory. This information will not be used for any other purpose and will not be distributed to anyone other than classmates or teachers.
Q20

Do you plan on attending our 25th reunion?
Q21

I give my permission to the Reunion Committee of UofK Faculty of Science Class of 1985 to include the above information in the Class Directory. This information will not be used for any other purpose and will not be distributed to anyone other than classmates or teachers.