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In order to guarantee you receive the benefits of your alumni status—BGSU Magazine, invitations to alumni events & mailings about services now available to you—please take a moment to complete the following information.
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Your information
*Last name
Maiden name
*Title (e.g. Mr., Mrs., Ms.)
*First name
*Middle name
Suffix (e.g. Sr., Jr.)
*Graduation year
*Street Address (and apartment number, if applicable)
*City
*State
*Zip code +4
*Date of birth
Preferred e-mail address
Seasonal address, if different than primary address (winter/summer)
Street Address
City
State
Zip Code +4
From (Month/Year)
To (Month/Year)
Your employer
Employer: (Company, Corporation, School, etc.)
Street address and suite number
Zip code +4
Telephone number (with area code)
Fax number(with area code)
Matching giftemployer?1Yes No
Business title or position
1To determine whether your employer matches gifts to BGSU, please visit this page.Your degrees
Bachelors Degree
Year Granted
Major Field of Study
School (e.g. BGSU, OSU, etc.)
Masters Degree
Ph. D.
Credentials or Certificate
Contact person
Name & address of someone who will most likely know your address at all times(Other than Spouse or Parents)
Relationship
Parent information
Mother’s Name and Address
BGSU Graduate? Yes No
Father’s Name and Address
Spouse information
First & Middle Name
Last Name
Date of Birth
PIN Number(If BGSU Grad)
Spouse business information
Street Address and Suite Number
Business Title or Position
Preferred Email Address
Telephone Number(with area code)
Matching Gift Employer?Yes No
Fraternity or sorority
Greek Letters:
Fraternity/Sorority Full Name:
Recognition
Awards:
Honor Societies:
Letterwinner in:
Organizations (Student or Professional):
Scholarships Received:
Have you ever attended BGSU Firelands? Yes No If yes, what year?
Would you like additional information on the following programs?
BGSU Alumni Chapter in your area Yes NoStudent Recruitment Yes NoAlumni Association Events Yes NoHomecoming Yes No