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 Stub Hub events, health, home and auto insurance and many more. Join the Alumni Association today!

Personal Information
Prefix *   
First Name *  
Middle Name
Last Name *  

Birthday * (MM/DD/YYYY)     
Address 1 *  
Address 2
City *  
State *  
Zip *  
Home Phone *      
Cell Phone *      
Email *    
Employment Information
Position Title
Address 1
Address 2
Bus. Phone   
Bus. Fax   
Bus. Email   
Education Information
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.  
Family Information
Spouse's First Name
Spouse's Last Name
Is spouse a CSUDH Alum?   
Number of children
Give us your children name(s) if any
Other Information
Please contact me for the following opportunities

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