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Contact Information

Have you moved? Do you have a new e-mail address? Did you get married? We want to know!

Please keep us informed so we can update our records! This form will be sent to the Record Division of the Purdue Alumni Association. If not already done so, your name will be flagged as a Mortar Board Alumni, so you can be assured you will receive all Mortar Board mailings.

Thank you for updating your contact information! We appreciate your continued involvement! Please fill out this form as completely as possible. If you feel that you are not receiving Mortar Board mailings, put your current address in the OLD Address field and submit the form. By doing this, your records will be flagged as a Mortar Board Alumni. In any case, this form will be sent to the Records Division of the Purdue Alumni Association for processing.

Contact Update Form

First Name
Middle Name
Last Name
Name used at Purdue
Spouse's Name
OLD Home Address
Street
City
State/Province
Zip Code/Postal Code
Country
Home Phone Number (include country/city code)
Home E-mail Address
NEW Home Address
Street
City
State/Province
Zip Code/Postal Code
Country
Home Phone Number (include country/city code)
Home E-mail Address
Year of Graduation
School/Major/Program
Major Professor
Birthdate (mm/dd/yyyy)
 
  
       

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Updated: 09/15/07 05:40 PM