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Name
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Mr.
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Surname:
Given Names:
Former Name:
Graduation
Student Number:
Birthdate: (YY/MM/DD)
Year of Graduation:
Degree, Certificate & Citation:
Major:
Home Address
Address Line 1:
Address Line 2:
City:
Province/State:
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Country:
Home Telephone:
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Home Fax:
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Home E-mail:
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Business Address
Company:
Position/Title:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 4:
City:
Province/State:
Postal Code/Zip:
Country:
Business Telephone:
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Business Fax:
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Business E-mail:
Enter a valid email address. Example: name@company.com
Spouse/Partner (if applicable)
Name:
Partner's Former Name:
Partner attended Kwantlen?:
Yes
No
Student Number:
Birthdate: (YY/MM/DD)
Year of Graduation:
Degree, certificate & Citation:
Home E-mail:
Enter a valid email address. Example: name@company.com
If partner is a Kwantlen grad, do you wish to receive only one piece of mail?
Yes
No
Comments/Feedback
Comments:
I would like to learn more about alumni volunteer opportunities:
Yes
I would like to learn more about making a planned gift to Kwantlen.
Yes
I would be interested in organizing a reunion.
Yes
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