ALUMNI FORM

Congratulations! - upon graduation you become an alumnus of the Geraldton Universities Centre. The relationship forged with the Centre and your affiliated University is a life long one, through the friendships you have made, the skills and knowledge gained and the opportunities provided.

Please complete the Alumni form below, so that you can be contacted after you have graduated. You will receive the GUC Newsletters, invitations to events and other alumni news.

Please use BLOCK/CAPITAL letters and hand deliver to:

GUC Student Services Office

Geraldton Universities Centre

Onslow Street

Geraldton WA 6531

You can also post your submission to:

GUC Student Services Office

Geraldton Universities Centre

PO Box 2779

Geraldton WA 6531

Please complete the following online form:

(NOTE: Sections with red titles are compulsory and need to be completed before the form will send)

Personal Details
Title:	--?-- Mr Mrs Miss Ms Dr Other If Other
First Name:
Last Name:
Preferred Name: (If different from above)
Graduation Name: (Name at graduation if different from above)
Date of Birth: Use format dd/mm/yyyy
Address:
Email:
Your Phone Numbers
Business Hours:
Mobile:
Fax:
Qualifications
Student Number: (If known)
Institution:
Name of Course:
Year of Course Completion:
Employment Details
Company Name:
Position Held:
Work Address:
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