Salem State College: Alumni Update Form

Salem State College
352 Lafayette Street
Salem, MA 01970
978-542-6000

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Alumni Affairs

Alumni Update Form

We invite all Salem State Alumni who visit this site to fill out the following information, which will be compiled and added to our databases. With your permission, we will also include you in our Online Database of Alumni through the Decades. If you have any problems or questions with this form, please email alumni@salemstate.edu

After your complete this form, you will be shown a confirmation screen. Using the "Back" button on your browser, you can navigate back to the Alumni page.

So, scroll down and fill in the blanks! We are not "requiring" you to fill out all of the choices, but we really would appreciate it if you did. Thanks for taking the time to keep us informed!

First Name:	Middle Initial
Last Name While Attending:
Current Last Name:
Yr of Graduation:	Major:
Current Permanent Address
Street:
City:
State:
Zip:
Seasonal address, if any
Dates at this address:
Street:
City:
State:
Zip Code:

Home Phone Number:
Work Phone Number:

E-Mail Address:
Do you wish to be included in our on-line e-mail directory?	Yes No

Occupational Information
Employer:
Title:
Business Address:
City:
State:
Zip Code:
Does your company have a matching gift program?	Yes No

Other Educational Institutions Attended:
Degree Earned:

Spouse Information
First Name:
Last Name:
Employer:
Title:
Educational Institution:

Are there any areas of particular interest to you as an alum?

Thanks for taking the time to keep us updated!