Alumni Association Registration Form

NEIT Alumni Association Welcome to NEIT's Alumni Registration page. Please take the time to complete the information below. The information you provide will allow us to keep in contact with you regarding Alumni Association information. We are excited about the new Alumni Association and look forward to your participation.

Contact Information
*First Name:
Middle Initial:
*Last Name:
Maiden Name (if used while attending NEIT):
*Street Address:
Apt. Number:
*City:
*State:
*Zip Code:
Country:
*Is this a new address since attending NEIT?	Yes No
Home Phone:
Cell Phone:
*Email:

You completed NEIT with (include all that apply):
Associate Degree	Technology:	Year:
Bachelor Degree	Technology:	Year:
Other	Program:	Year:

Student ID:
or last 4 digits of SSN:
(Used to distinguish between graduates with same/similar names.)
*Date of Birth: //

Employment Information
Company Name:
Street Address:
City:
State:
Zip Code:
Job Title:

Getting Involved

I would like to be involved in the Alumni Association in the following ways
Check as many as you would like (Ctrl click PC, cmd click Mac):

Attend Alumni Association events
Participate on the Alumni Association Advisory Committee
Participate in planning Alumni Association events
Volunteer at Alumni Association events
Participate in class presentations to NEIT students
Participate in panel discussions for NEIT students
Participate in informational interviews with students and graduates
Speak with prospective students regarding programs
Other

Please list below any and all alumni activities and benefits that would be of interest to you.