Alumni Questionnaire

May we use your comments in promotional printed publications or on the web site?

Yes No
May we share information with you about Riverland activities and programs?

Yes No

Riverland Community College is committed to protecting any personal information that you may provide. We will never share, sell, or rent your personal information with third-party vendors.

Personal Information:

First Name:		Last Name:
Maiden Name:		Nick Name:
Date of Birth:	(12/14/1994)
Current Home Address:
City		State	Zip
Phone (landline)		Phone (mobile)
E-mail		Website
Other social networking addresses (Facebook, Twitter, etc)
	Single Married
Spouse/Partner	First Name Last Name Birth date:
Children	Name and Date of Birth

Riverland Information:

Degree:		Grad Year:
Certificate		Grad Year:

What clubs/sports/activities did you participate in?
Favorite Class(es):
Favorite Teacher(es):
Favorite Memory(ies):

What are you doing now? Working?

Organization Name:
Position:
Address
City
State
Zip

Continuing Education?

College/University Name:
Major:

Military Service

Rank:
Branch

Retired

From:
Years of Service:

Honors & Awards? What & When Personal & Professional Achievements? What & When Other? Help us improve our Alumni Page - Give us your Suggestions:

About Us \| Contact Us \| Employment \| Feedback	RIVERLAND Campuses Albert Lea \| 2200 Riverland Dr. \| Albert Lea, MN 56007 \| 507-379-3300 Austin Campus \| 1900 8th Avenue NW \| Austin, MN 55912 \| 507-433-0600 Owatonna Campus \| 965 Alexander Drive SW \| Owatonna, MN 55060 \| 507-455-5880
800.247.5039