Thank You for Expressing an Interest in Becoming More Involved with the Ohiostateuniversity

Thank you for expressing an interest in becoming more involved with The OhioStateUniversity Alumni Association.

We would love to learn more about you,and we appreciate your willingness to provide us with the information requested.

YOUR INFORMATION
Honorific (Ms./Mr./Dr.) / First Name / Middle
Initial / Last Name / Suffix / Date of Birth
Home Address / Home Phone and E-mail
Home Phone:
Home Cell Phone:
Home E-mail:
Month/year graduated from Ohio State / OhioState
degree(s) received / Month/year graduated from
other institutions / Degree(s) received
(and name of other institutions)
Current Employment Information (Title, Company, Address) / Work Phone and E-mail
Work Phone:
Work Cell Phone:
Work E-mail:
Most Recent Previous Employment Information (Title, Company, Address)
(1) / (2)
Preferred method(s) of contact (check all that apply):
Home Phone / E-mail – Home / Home Address (for mailings)
Home Cell Phone / E-mail – Work / Work Address (for mailings)
Work Phone
Work Cell Phone

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OPTIONAL Information

SPOUSE / DOMESTIC PARTNER INFORMATION
Honorific
(Ms./Mr./Dr.) / First Name / Middle
Initial / Last Name / Suffix / Date of Birth
Month/year graduated from Ohio State / OhioState
degree(s) received / Month/year graduated from
other institutions / Degree(s) received
(and name of other institutions)
Current Employment Information (Title, Company, Address) / Work Phone and E-mail Information
Work Phone:
Work E-mail:
Tell us about yourself!
What activities were you involved in during your years at Ohio State?
What honors/awards have you received from
Ohio State, either as a student or since then?
What is your current professional/civic/community involvement and in what capacity?Leadership roles?
What are your past professional/civic/community involvement/pastleadership roles?
What diversity activities are you/have you been involved in, whether professionally or personally?
What Alumni Association events have you participated in and when?
What are you currently involved in at Ohio State?
What are you currently involved in at the
Alumni Association?
What interests you in becoming more involved with the Alumni Association?
In what way(s) would you like to apply your skills in service to the Alumni Association?
How can the Alumni Association better serve alumni? (You may use a separate sheet to answer this question; please limit your answer to one page.)
Describe your major accomplishments—personal and/or professional.
What is your favorite Ohio State memory?
Is there anyone whom you would recommend sending this form to who is interested in becoming more involved with The Ohio State University Alumni Association? If so, please provide name/address/e-mail information to the right.

Thank you for taking the time to complete this form.

We value your interest in and support of the Ohio State Alumni Association.

Ways to submit the questionnaire:

E-mail (preferred): / (subject line: Questionnaire)
Fax: / 614-292-7697
Mail: / President’s Office | Longaberger Alumni House | 2200 Olentangy River Road | Columbus, OH 43210-1035
Questions? / Please e-mail us at: