Suffolk University - International Alumni Update Form

Information about person submitting this request:
Full Name:
Daytime Phone:
Extension:
(This information is requested only in the event that the person submitting the form is not the Alumnus. This information will only be used if the Alumni Relations Office needs to contact you and will not become part of the Alumnus' record.)

Current Name:
Last Name:
First Name:
Middle Name:
Name As Student ( if Different ):
Last Name:
First Name:
Middle Name:
Date of Birth:	(mm/dd/yyyy)
Year of Graduation from Suffolk:
Degree Received from Suffolk: (most recent if multiple)
Current Home Address Information:
Street:
City:
State:
Zip/Postal Code:
Country: (If not in the USA)
Home Phone: (please include Area Code)
Preferred Email Address:
Current Business Information:
Company Name:
Job Title:
Business Street Address:
City:
State:
Zip/Postal Code:
Business Telephone: (please include Area Code)
Business Fax: (please include Area Code)
I prefer to receive my correspondence at home / business.
Additional Notes for Clarification:	Please provide any other information we may need to process your change of address.

For problems/questions regarding this form please call (617) 573-8443.