Please copy the form, fill it out and FAX it to the
Alumnae/i Office at
(718) 405-3748 or copy it to an e-mail and send it to
Name_________________________________________________
Class__________________ Major__________________________
Address_______________________________________________
_______________________________________________
Phone (home)______________ cell phone_____________________
e-mail_________________________________________________
Business Name__________________________________________
Business Address
________________________________________
________________________________________
Business Phone__________________________________________
Position ________________________________________________
Advanced Degree/
School _________________________________
_________________________________
Spouses' Name (if applicable) _______________________________
Spouses' Business ________________________________________
Position ________________________________











