Keene State College

Contact Information

* = required field

*First Name :

*Last Name :

Maiden Name/Former Name:

Nickname:

Spouse/Partner Name:

Spouse/Partner KSC Class (if Applicable):

*Street Address or P.O. Box:

*City:

*State:

*Zip Code:

Country:

*Preferred Email:

Add me to the Alumni E-mail Directory
Yes No

*Phone: (please enter area code first)
Area code:
Phone Number:
This number is my: Home | Cell | Work

KSC Experience

Reunion Year: Major:

Campus Affiliations (clubs, teams, intramurals, leadership, etc.) as an undergraduate at KSC:

Organization Name:
Leadership Position (if Applicable):

Organization Name:
Leadership Position (if Applicable):

Employment/Career

Which statement best describes your employment status right now? (Mark all that Apply)

Employed - Full Time
Employed - Part Time
Not Employed - Seeking Employment
Not Employed - NOT Seeking Employment
Student
Raising a family
Volunteer
Retired
Not working for other reasons

Current Employer

Position/Title

Is your current position related to your undergraduate field(s) of study?

Yes, same field as major(s)
Yes, related to major(s)
No, not related

Are you retired? If so, when did you retire?

When you were employed, what were your career interests? Please describe.

Interests & Activities

Professional Interests

Civic & Community Activities

Is there anything else you would like to share? (memorable trips, exciting changes in your life, hobbies)

Post-KSC Study

Credential/Certificate/Other

Year Graduated/completed
College/University/Institution