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    Title

    First Name*

    Middle Name

    Last Name*

    Suffix

    Former name(s) (If your surname has changed)

    Address (Parent's or other permanent address)*

    Address line 2

    City*

    State*

    Zip Code*

    Home Phone Number

    Cell Phone Number

    Email address (Not your NSU email)*

    Birthday (MMDDYYYY)*

    Degree Information

    Year Graduated

    Degree 1

    Major 1

    Degree Term 1:

    Degree 2

    Major 2

    Degree Term 2:

    Spouse Information (Optional)

    Spouse First Name

    Spouse last Name

    Is Your Spouse An NSU Graduate?

    Employment Information (Optional)

    Business Name

    Job Title (if known):

    Business Address 1:

    Business Address 2:

    Business City:

    Business Country:

    Business E-mail:

    Business Phone:

    Business State:

    Business Zip:

    Student Involvement (Optional)

    What organization(s) were you a member of at NSU?

    Other student group (not listed above)

    NSU Athletics