CT State Middlesex - Alumni Association Form

Full Name(*)

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Last Name while attending Middlesex - if different

Please let us know your name.

Phone

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Cell Phone

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Email address(*)

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Relationship to CT State Middlesex (formerly Middlesex Community College)

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Year of graduation (if applicable)(*)

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Age at graduation

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What did you study at Middlesex?(*)

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What certificate or degree (credit or non-credit) did you earn?

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Did you transfer into another college/university? If so, where?

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Did you earn any other degrees at another institution?

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Please describe any other achievements:

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Profession/Occupation

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Current employer

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Home Address 1

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Home Address 2

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City

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State

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Zip Code

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Upload a photo to go with your story

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2MB Maximum, JPG or PNG

Would you like to

participate in the student mentoring programvolunteer for the Foundationattend eventsdonate to the Foundation

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What types of events are you interested in?

networking/careerpanel discussion/speakerfundraisingmeet and greet in the community

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Other event ideas

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