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History & Government

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Alumnae Registration

  1. What is your name? (Required)    

  2. What is your email address? (Required)   

  3. What is your address? (Required)    

  4. What city do you reside? (Required)    

  5. What state do you currently reside? (Required. If you do not reside in the U.S., please select "None" and move to the next question.)

  6. If you do not currently reside in the U.S., please choose country or territory. (Required. If you reside in the U.S., please select United States)

            

     

  7. What is your zip or country postal code? (Required)    

  8. May we contact you?     Yes No
         If no, please skip to next question. If yes, what is your preference of contact?

        E-mail (Double-check to make sure your email address is correct above)
      
    U.S. Postal Service (Double-check to make sure your address is correct above)
      
    Phone Call
          Your phone number, please 
       Fax 
          Your fax number, please  

     

  9. Do you have a web site?     Yes No

      If no, skip to next question. If yes, what is the url?

       

  10. What year did you graduate?    

  11. Do you have an announcement or "good news" you would like to share for a possible announcements page?



  12. Would you like to help in any of the areas outlined at the chapter site?

    Yes No
      If no, please continue with next question. If yes, with what program and how?


  13. What features would you like to see at this site?   



  14. (Optional) Would your company or business be interested in any of our programs? If yes, please provide us with the name, address, phone number and person to contact.


Thank you for taking the time to fill out our questionnaire. We appreciate the effort and hope to hear from you soon.

 

 

 

Page last updated January 19, 2006

History & Government
CFO 605
P.O. Box 425889
Denton, TX 76204-5889
940.898.2133 | fax: 940.898.2130

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