Update Your Information Please help us keep our records up to date by completing the form below.Required fields are in bold. Personal Information First Name: Last Name: Maiden Name: Email Address: Address: City: State: AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code: Preferred Phone Number: Birthday: Career Information Are you currently employed? Yes No Prefer not to answer Employer: Title/Position: Start Date: Is this a new job? Yes No If you are seeking employment, please share your intended career field: Educational Information Student ID Seminole State Graduation Date: Campus Affiliation: Sanford/Lake Mary Oviedo Altamonte Springs Heathrow Online Did you participate in on campus activities? If yes, please list. Do you have additional education you'd like to share with us? Yes No Educational Institution(s) Program/Degree Graduation/Attendance Date Spouse Information Is your Spouse an alumnus? Yes No Spouse's First Name: Spouse's Last Name: Alumni Association Please select what brought you to complete this form: Change of Address Updating Email Address/Phone Number Change of Name Career Center Access Change of job Want to get involved Want to get information Want to share an update about myself Other I would like more information on the Alumni Association Yes No I would like to get more involved by volunteering my time Yes No Maybe I would like more information about the following Chapter of the Alumni Association: Design and Construction Chapter No Thank You Tell us why you chose to Go State, and how it changed your life Additional Comments? Submit
