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Alumni Information Form

Personal Information

Title*
First Name*
First Name
Mi
Middle Initial
Last Name*
Last Name
Maiden Name
Maiden Name
Suffix
Suffix
Preferred First Name or Nickname
Address*
Address
Address (2)
Address (2)
City*
City
State*
Province
Province
Zip*
Zip
Graduate Year*
Year
E-mail*
E-mail
Phone No.
Phone No.
International Address
International Address
Spouse's First Name
Spouse's First Name
Spouse's Maiden Name
Spouse's Maiden Name
Is Spouse a Malone Alumna/Alumnus?
Yes
No
Spouse’s Class Year

Job Information

Company Information
Company
Job Title
Job Title
Department
City
City
State
State
Province
Province
Business Industry
Choose an Industry that best describes your field
If 'Other' list here
Does Malone University have permission to use this information in the publication of the Directory and in the online directory or do you prefer that the information be used for internal purposes only?*
Yes, I give permission for this information to be used in the Directory publication and online
I prefer that this information is used for internal purposes only
I have reviewed the information on my questionnaire and it is correct*
Yes