Alumni Membership Form

Alumni Membership Form

Enter Your Details

To help us to develop services and communications which are of interest and value to you, please spare a few moments to complete this form:

1. Your Personal Details

Membership No:

Title:

Mr
Mrs
Miss
Ms
Dr
Prof
Other (please specify)
Surname:
Surname whilst at Cardiff (if different):
Forenames:
Preferred forename:
Distinctions (e.g. CBE, FRCP):

Sex:

Male
Female
Date of Birth: Marital Status:
Number of children: Ages of children:
Partner's Name:

If your partner was also at Cardiff would you prefer one mailing?

Yes
No
Address Line 1:
Address Line 2:
Address Line 3:
City / Town:
County:
Postcode:
Country (if outside UK):

Is this address:

Own home
Parents
Guardians
other
Home Phone (inc STD code):
Fax:
Email:

2. Your Study Details

<<B>From Cardiff University

Degree:
Subject:
Department:
Start Year:
End year:
Degree:
Subject:
Department:
Start Year:
End year:

Other HE/FE Qualifications

Institution:
Qualification:
Department:

Start Year:
End Year:

Your last School

Name of School:
Town/City:

Start Year:
End Year:

3. Your Employment Details

Current Employment Status:

Employed
Studying
Taking Time Out
Unemployed
Self Employed
Home Maker
Retired
Volunteer

Please give your present employment details or former if you have retired.

Job Title:
Company / Organisation:
Address Line 1: Address Line 2:
Address Line 3:
City / Town:
Postcode:
Work Phone (inc : STD code)
Your Email address at work:
Details of any directorships or trustships:
Company / Organisation sector:
Current Income (information for University purposes and will not be divulged)

4. Your contact details

Which is your preferred mailing address?

Home
Work

Have you received two copies of this questionnaire?

Yes
No

Which is your preferred email address?

Home
Work

I agree to the following information being included in the Online Alumni Directory

Name
Home Address
Job title & employer
Preferred Email Address
Work Address

5. Supporting Cardiff University

Making a donation

I am interested in making a gift to Cardiff University
I am interested in leaving a gift to Cardiff University in my will
I have made a bequest to Cardiff University in my will

Helping our Careers Service

Would you be interested in receiving details of our services for employers?

Yes
No

Helping our Research & Commercial division

Cardiff University is open for business with industry and commerce, and is committed to offering the most professional and appropriate solution to any enquiry. Free membership of the Cardiff University Innovation Network exists for anyone wanting to participate in the University's network of contacts. www.innovation-network.org.uk

Would your company be interested in learning more about the Research & Consultancy Division and the Cardiff University Innovation Network?

Yes
No

6. Cardiff University Students' Union

Would you be interested in receiving details of Cardiff University Students' Union Life Membership Scheme - 'Class Of'?

Yes
No

See www.cardiffstudents.com for more information.

Help us improve the Cardiff Student Experience

The Cardiff University Student Experience Unit (SEU) was established in 2004 and aims to enhance the experience of all students at Cardiff University. We would very much welcome the opportunity to hear the views of former studnets.

Would you be interested in assisting us to enhance the student experience at Cardiff University for current and future students by giving us detailed feedback on your experience as a student at Cardiff University?

Yes
No

In general, would you view your overall experience as a student at Cardiff University as:

Excellent
Average
Good
Poor

Further information about our work may be found on our website at www.cardiffstudents.com

8. Data Protection Act

All data is securely held in the University Alumni Office and will be treated confidentially and with sensitivity for the benefit of Cardiff University and its members. The data is available for Cardiff University educational, social and charitable purposes only and to agents contracted by the University for particular alumni-related projects which may contain an element of direct mail.

Under the terms of the 1998 Data Protection Act you have the right to object to the use of your data for any of the above purposes. Your personal information can be removed from the Alumni Database within one month of receiving a written request from you.

Development & Alumni Relations
- Alumni Relations
- Development

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