UPDATE YOUR INFORMATION
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Alumni Relations
Philadelphia University
School House Lane & Henry Avenue
Philadelphia, PA 19144-5497

Please help us to better serve you by completing this Alumni Survey. 
We appreciate your help in updating our records. Thank you.

Prefix (Mr., Mrs., Ms. Dr., etc.):  
First Name:  
Middle Name or Initial:  
Last Name:  
Suffix (Esq., etc.):  
Date of Birth:
   
Contact Information:  
Address
 
 		Province & Country (if other than U.S.)
City
 		Residence Phone (with area code)
State
 		E-Mail Address
Zip Code
 		 
       
Major and Undergraduate Degree at PhilaU
 		  Year Received
Graduate Degree at PhilaU
 		  Year Received
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Employment Information:
Employer
 		  Job Title
Employer Address
 
 		  Province & Country (if other than U.S.)
Employer City
 		  Business Phone (with area code)
Employer State
 		  Business Fax (with area code)
Employer Zip Code
 		  Employer has a Matching Gift Program:
 Yes    No
Family Information:
Spouse's Name
 		Date of Birth
Spouse's Employer
 		Spouse's Job Title
Spouse’s Employer Has Matching Gift Program
 Yes  No
   
Children - Name(s) & Date of Birth
1. 4.
2. 5.
3. 6.
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Please list the name, address, and phone number of  a person who would always know your address:
Contact Name
 		Contact Person Phone
What is your relationship to this person?
Contact Person Address
 
 		  Contact Person Country (if other than U.S.)
Contact Person City
 		  Contact Person Phone (with area code)
Contact Person State
 		  Contact Person E-Mail Address
Contact Person Zip Code
 		   
While you were at Philadelphia University in which campus organizations did you participate
(fraternity and sorority, clubs, varsity athletics, intramural teams, etc.)?
List any awards or scholarships you received while attending Philadelphia University.
(Please name the scholarship(s) if known.)
Class Notes
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Additional Comments. We value your comments and want to hear from you. Thank you.
 
Planned Giving:
I have made provision for Philadelphia University in my estate plans.
I would like more information about planned giving.