Alumni Association Membership Application

Dear , 
Thank you for submitting your application to join the CSUDH Alumni Association. Below is a copy of what you have submitted to us, which is under review. Membership will be applied after your degree and/or credential is confirmed in your student record. You will receive a letter and membership card at the address provided on the application, once confirmed.

*Due to campus safety measures taken to limit the spread of coronavirus, mailing of membership cards will be delayed. For more information about campus safety measures against COVID-19, go to https://www.csudh.edu/alert

Personal Information

Prefix
First Name
Middle Name
Last Name
Birthday
Address
Home Phone
Cell Phone
Email

Employment Information

Employer
Position Title
Address
Bus. Phone
Bus. Fax
Bus. Email

Education Information

Degree/Credential 1
Major 1
Grad Year 1
Minor 1
Degree/Credential 2
Major 2
Grad Year 2
Minor 2
Affiliation

Family Information

Spouse's Name
Is spouse a CSUDH Alum?
Number of children

Other Information

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