Form – Alumni Information Update – EEA

Name, spouse, and class year

Name*

Include name while attending the University of Rochester if applicable

Spouse/partner's name

School(s)*

Eastman Institute for Oral Health
Eastman School of Music
Hajim School of Engineering & Applied Sciences
School of Arts & Sciences
School of Medicine and Dentistry
School of Nursing
Simon Business School
Warner School of Education

Undergraduate or graduate?*

Undergraduate
Graduate

Graduation year(s)*

If undergraduate, include year of your graduation. If graduate, include the year you received your master’s, MBA, PhD, MD, DDS, DMD, or other degree.

Majors/minors/program areas

Contact information

Home address*

City*

State

Zip code

Country*

Home phone

Cell phone

Personal email address*

Reunion

Are you coming back for your reunion?

Yes
Maybe, unsure yet
No

Do you want to be involved as a volunteer for your class reunion?

Yes! Please contact me!
No, thank you.

Employment information

Company name

Title

Business address

City

State

Zip code

Country

Business phone

Business fax

Business email

Other, please indicate

Field of professional work (as applicable)

Student affiliations

If applicable, please share the name of your first-year dorm on the River Campus or at the Eastman School of Music

Other, please indicate

If applicable, please list any special housing you lived in

If applicable, please list sports you were involved in

If applicable, please list clubs, organizations, music ensembles you were involved in

Eastman alumni only: Please list key professors that you worked with outside of your studio professor

��Թ�

Alumni information update form – inside of EEA

Name, spouse, and class year

Contact information

Reunion

Employment information

Student affiliations

�����Թ�

Alumni information update form – inside of EEA

Name, spouse, and class year

Contact information

Reunion

Employment information

Student affiliations

��Թ�