Skip to main content

Alumni Information Drive

The Mature Alumni Group has been assembling information to highlight our distinguished Alumni and keep everyone in touch.  This informaion is for us only and is designed to plan better events and communication.

Dowload PDF            Download Word Doccument      email info to cahenika@hotmail.com

 

Full Name________________________________________Nickname_________________Birth date____/____/_____

 

Spouse (include maiden name)_______________________________________________________________________________________

 

Address________________________________PO______________________City_________________Zip_______Date from_____to_____

 

Address________________________________PO______________________City_________________Zip_______Date from_____to_____

 

Telephone (______)____________________________Cell #______________________________Other #____________________________

 

E-mail address________________________________________________________

 

Hometown (where you grew up) _____________________________ HS name_________________________ Yr. HS grad________

 

Year first Enrolled at UW-Madison: _____________________ Year Activated into DTS: _______------______ Spring or fall (circle one)

 

Year BS Grad. UW-_______Major(s)________________________________________________AdvisOr_______________________

 

Additional degrees (Univ./date/degree/major)_____________________________________________________________________

 

__________________________________________________________________________________________________________

 

Career/Occupation Summary_____________________________________________________________________________________________

 

__________________________________________________________________________________________________________