MSU College of Nursing


	Alumini and Friends Keeping in Touch WE'D LIKE TO KNOW ABOUT YOU Alumni Update Are you listed on the Lost List? Have you lost touch with the College of Nursing? Fill out the form below to let the College of Nursing know where you are and how we can get in touch with you! NOTE: Use the Tab key or your mouse to move between fields - pressing the Enter key will submit your form. To submit your form, push the "Submit" button at the end of the form after filling out all the appropriate information. Pushing the "Clear All Fields" button at the bottom of the form will clear all fields on the form. Current Name (first middle last): Name while at MSU (if different): Nursing Degree: Graduation Year: Location? On-Campus Lansing BSN Muskegon MSN Northern Michigan MSN Are you an Alumni Association member? Yes No Spouse's Name (if applicable): Spouse's Occupation: Is your spouse an MSU alumnus? Yes No Home Street Address: City: State: ZIP: Home Phone: Work Phone: E-mail Address: Fax Number: Employer/Department: Position/Title: Work Street Address: City: State: ZIP: Salary (confidential): Primary Care Practice? Yes No Medically Underserved? Yes No Professional and Educational Achievements: Additional Degrees (university, degree, year): Family and Personal Accomplishments: