Your information:

Prefix: Mr. Mrs. Ms. Dr.
First Name:
Middle Name:
Last Name:
Suffix Sr. Jr. 1st  2nd  3rd
Maiden Name (if applicable):
Address:
City:
State:
Zip Code:
Home Phone:
Mobile Phone:
Fax Number:
Email:
Marital Status:
   
Work Information:  
   
Employer:
Job Title:
Work Phone:
Work Address:
City:
State:
Zip Code:
Is This A New Position/Employer: Yes No
   
About Your Years at UW-Parkside:
   
Year of Graduation:
Major
Minor / Certificate:
   

Please give a brief description about your life after UWP.

Please list any and all areas of expertise (ie. PR, Special Event, etc.):

Would you be interested in the following?:                                                                    Mentoring     Job Shadowing        Internships       Networking

Thank You for updating your information - Please return to this form when you would like to update your information when your information chages.

*NOTE - Information entered into this form will automatically be given to the UWP Alumni Association and to the PCAA advisor.