CSUDH Alumni Association Membership Application

Join and take advantage of the programs and services offered by the California State University, Dominguez Hills Alumni Association. The CSUDH Alumni Association offers valuable programs to foster connections among all alumni, while providing special benefits for members including exclusive discounts to university events, the University Bookstore, private events in the LSU, selective Dignity Health Sports Park events, health, home and auto insurance and many more. Join the Alumni Association today!

Please contact the Alumni Relations office at (310) 243-2237 if you have any questions about this form.

Prefix *	Required
First Name *	Required
Middle Name
Last Name *	Required
Please check this box if your name was different while attending CSUDH
Birthday *	(MM/DD/YYYY) Required invalid date
Address 1 *	Required
Address 2
City *	Required
State *	Required
Zip *	Required
Country
Home Phone *	Invalide Phone Required
Cell Phone *	Invalide Phone Required
Email *	Required invalid email

Employer
Position Title
Address 1
Address 2
City
State
Zip
Country
Bus. Phone	Invalide Phone
Bus. Fax	Invalide Fax
Bus. Email	invalid email

Degree/Credential 1
Major 1
Grad Year 1	(Spring 2009)
Minor 1
Degree/Credential 2
Major 2
Grad Year 2	(Spring 2009)
Minor 2
Check all boxes which Affiliation are applicable.	Associated Students, Inc.
	Athlete
	Education Opportunity Program
	Encounter to Excellence
	Honor Society
	President Scholar
	University Housing
	Veteran
	Student Organization
	Student Success Services
	Other

Spouse's First Name
Spouse's Last Name
Is spouse a CSUDH Alum?	Yes No
Number of children	Give us your children name(s) if any