Kearns Alumni Survey

You've graduated and moved on to great things! We would love to be able to update your contact information and send you updates, invitations to local events, and information about current students!

Please fill out this quick survey! Thank you!

Name

First Name Last Name

Current Mailing Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Personal E-mail

Phone Number

Area Code Phone Number

Were you a first-generation student when you were an undergraduate student?

Yes No

What are the best methods to contact you?

Phone E-mail Mail Social Media Text Message

What is your Facebook Name/Link?

What is your LinkedIn URL?

What program are you an alumna/us of? (Check all that apply)

UB/UBMS McNair Kearns Scholar Xerox

If you checked one of the above options, what class year were you a part of?

What personal updates would you like to share with us?

What have you done academically since leaving our programs?

Tell us about your professional/career path since leaving our programs?

Would you like to provide us with a testimonial

Would you be interested in any of the following opportunities?

Attending Kearns Center events Participating in virtual meetings with students Participating in workshops/panels Attending a Kearns networking event in your area Hosting a Kearns networking event in your area Writing a brief testimonial about your experience with Kearns

Are you interested in attending Kearns Center Events?

Are you willing/able to participate in virtual meetings with current students?

Would you be interested in participating in Kearns Center workshops/seminars/panels?

Are you interested in attending Kearns Center networking events in your local area?

Would you be willing to write a brief testimonial or narrative about the impact that the Kearns Center/McNair had on your education?

Would you be interested in serving as a mentor to current/future Kearns Center pre-college, college, or graduate students?

Your communications preferences are important to us. You can choose how you would like to be kept in touch, by post, telephone, and email, by providing your information above. Any corrections you make are greatly appreciated.

Your contact details are used to provide you with information about:

University and/or Kearns Center news
Events
Opportunities to support the Kearns Center

By submitting this form, you agree to allow the David T. Kearns Center to contact you via phone, email, mail or social media in regards to alumni news and events.