Alumni Profile Form

Please take the time to fill out our CCRI Alumni profile. The information you supply will help the CCRI Alumni Office with future mailings and contact information.

Name:
Maiden Name:
Address:
Date of Birth:
Home Phone:
Home E-Mail:
Home Fax Number:
Company Name:
Business/Professional Title:
Business Address:
Business Telephone:
Business FAX:
Business E-Mail:
Preferred Mailing Address: Home Business
Salary Range: Under $20,000
$20,000 to $29,999
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
Over $60,000
Highest Level of Education: Associates Degree
Bachelor Degree
Advanced Degree (MBA, MS, MA, PhD)
Professional Degree (JD, MD, DDS)
Would you like to become involved with CCRI Alumni?
Yes
No 		Alumni Event Volunteer
Alumni Association Board Member
Foundation Trustee
Spouse Information
Spouse Name:
Company Name:
Business/Professional Title:
Business Address:
Business Telephone:
Business FAX:
Business E-Mail:

CCRI Testimonial

The Alumni Association is always looking for CCRI success stories and testimonials about alumni’s experiences at CCRI and how the college and its faculty and have made a difference in their lives.

How did CCRI help you in your career?


I give you my permission to use this information in letters and publications

I do not give my permission to use this information in letters and publications