Alumni Questionnaire

If you would like to keep in touch, please complete this form to add yourself to our Alumni database. We respect your privacy, and will not share the information you provide with anyone outside the Department without your prior permission.
Form fields outlined in red are required.

Current Information First Name:
Middle Name:
Last Name:
Nickname:
Primary Email:
Secondary Email:

UCSD Graduation Information Degree Type:
Graduation Term:
Graduation Year: Specialization:
Thesis Advisor(s):

Student ID Number:
I graduated under a different name:

Other Degrees I have one or more degrees from other insitutions:

Degree #1 Degree Type:
Institution:
Graduation Term:
Graduation Year: Specialization:

Degree #2 Degree Type:
Institution:
Graduation Term:
Graduation Year: Specialization:

Employer Information This is my...
Employer Name:
Employer Location:
Job Title:
I am now retired:

Other Information Honors & Awards: