Please complete all relevant sections of this form. If you have any problems completing or submitting this form, please contact Chris Humphreys.
Mr / Mrs / Ms / Miss
Mr Mrs Ms Miss Dr Professor Reverend
First Name(s)
Initial(s)
Surname
Maiden Name / Name at University (if applicable)
Reference number (if known)
Sex
Male Female
Date of Birth
Your Address
Is the above address
Home Parental Work
Telephone
Fax
E-mail address
Degree Award (BSc, MA, etc)
Course of Study
Graduation Year
Please give details of any further Newcastle degrees here
Is your partner also a Newcastle alumnus?
Yes No
Name of Partner
Her* Maiden Name (*if applicable)
His/Her degree details
Are you:
Employed Self Employed Seeking Employment Retired Further Study Family Commitments
Please select whichever one of the following best describes your employer's Industry Sector
--(Select)-- Agriculture, Horticulture, Forestry Architecture, Construction, Property Arts, Fashion Automotive Engineering Aviation, Aerospace, Defense Eng. Biotechnology Charities and Voluntary Organisations Chemicals Clothing and Textiles Culture and Heritage Industries Electronics, Control Systems Engineering, N.E.C. Facilities Management Finance, Insurance, Audit, Tax, Risk Food and Drink Health and Social Services Human Resources, Recruitment IT, Telecoms, Informatics Law Manage. Consultancy, Business Support Manufacturing, Production Marine and Offshore Technology Marine Science (Biology) Materials Media, Publishing, Printing Medical Devices, Diagnostics Mineral Products, Ceramics, Metals Pharmaceuticals Physical Resources, Environment, Conservation Plastics and Packaging PR, Advertising, Marketing, Market Research Public Sector, Armed and Uniformed Services Quality, Health and Safety, Env. Management Retail, Wholesale, Rental Training, Education Transport, Distribution, Logistics Transport, Tourism, Sport, Leisure, Hospitality Utilities, Energy, Oil and Gas
Please give details of your present employment (or former employment if retired)
Profession
Job Title
Company
Company Address
Work Tel
Work Fax
Work E-mail
What is your annual earning level? (NB: we respect the choice of respondents not to complete this section if preferred)
Under £15k £15–£25k £25–£40k £40–£60k £60–£100k £150–£250k £250k+
Which of the following Alumni services are of interest to you?
Exclusive offers and discounts Personal development (eg use of library and sports facilities) Information on forthcoming reunions and events Business development services News and other web-based activities (eg online directory and forums)
Do you have any suggestions of your own?
Would you be willing to travel to events in:
Newcastle upon Tyne London Other Location(s) (please state)
Are you interested in becoming involved with:
Organising alumni events in your area Helping with the University's student recruitment activity
Would you or your employer be interested in advertising graduate and work experience vacancies FREE to our students and graduates?
Work Experience, vacation work, placements Graduate Vacancies
Would you or your employer be interested in assisting the Careers Service with:
Mentoring Students Giving Information to students interested in your job or industry sector
Which friends from Newcastle University are you still in touch with?
What are your interests/hobbies?
Let us know your news (please tick this box if you do not wish your news to be published)
Are you a Company Director/Trustee?
If yes, please give details
Do you have any links with Charitable Trusts/Foundations?
I am happy for my personal data to be used for the purposes stated below (please tick)
All data is securely held in the Development and Alumni Relations Office. It is treated confidentially and with sensitivity for the benefit of Newcastle University and its members. The data is available to our faculties, academic Schools and administrative departments, recognised alumni leaders, and to agents contracted by the University for specific alumni-related projects. Data is used for a full range of alumni activities including the sending of University publications, the promotion of benefits and services available to alumni, notification of alumni events and programmes involving academic Schools and administrative departments. Data may also be used in fund-raising programmes which might include an element of direct marketing. 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.