Alumni Information Form

The Department of Physics and Astronomy would like to stay in touch with our alumni. Please complete the questionaire below to update us on what is going on in your life.

Items with an * indicate a required field.

First Name *
Last Name *
Maiden Name
Address Line 1
Address Line 2
City *
State *
Zip
Phone
E-mail address *
Degree obtained from BSU
BSU Graduation Year
Current Employer
Current Title
Memoriable experience in a BSU Physics class that you would like to share

Tell us about your achievements since leaving BSU

Comments or news

May we add your profile to our Alumni web page? *	Yes No

Please click the Submit button to complete the form. Thank you.