ECU Alumni and Development

Registration for Alumni Advantage Program

Please complete this form online, if any problems are encountered, kindly download the form, print, complete and forward/fax to the Alumni Office, as printed in the form.

Personal Information
Student Number: (if known)		Title:
First name:		Middle name:
Surname:		Name at Graduation
Date of birth:		Marital Status:

Address
Street Number:		Street Name:
Suburb:		State:
Postcode		Country :
Home Phone:		Mobile:
Facsimile:		Email:
Do you accept that your official student record will be updated to reflect this change? Yes, update my official student record.

Work Details
Position:
Organisation:
Work Phone:
Work Address:

Do you wish to be placed on the register of Alumni to participate in the election of an Alumnus to the Council of ECU?	Yes No

Would you be willing to volunteer on behalf of the ECU Alumni at certain ECU Events eg. Open Days?	Yes No

Would you like to attend corporate events run by ECU?	Yes No

Please read and sign the acknowledgement below to access the ECU library subject

I agree that should I use the ECU library subject database it will be solely for my own personal research and educational use, and such access will not act as a substitute for my business or employer obtaining access to the database.

By ticking this box, I accept all conditions of membership as stated on this form.

Welcome

Alumni

Foundation

Contact Alumni

Registration for Alumni Advantage Program

Personal Information

Address

Work Details

Please read and sign the acknowledgement below to access the ECU library subject