Alumni Form

Date:*

First Name:*

Last Name:*

Your Mailing Address:*

City:*

State:*

Zip*

Phone:(XXX) XXX-XXXX

Email Address:*

Social Media Handles/URL:Provide any social media handles you would like the program to connect with.

Are you currently enrolled in a postgraduate program?*

Yes

No

Institution:

Major(s)/Area(s) of Study:

Semester in School:

1st year graduate/professional

2nd year graduate/professional

3rd year graduate/professional

4th year graduate/professional

Beyond 4th year graduate/professional

Do you have an assistantship?

Yes

No

Date of Enrollment:

Did you take a graduate admission exam?

Yes

No

If you checked "Yes," please specify which one.

MCAT

GRE

LSAT

DAT

GMAT

Anticipated Graduation Date:

Have you earned a master's degree?*

Yes

No

If you checked "Yes," please specify which one:

Master of Arts (MA)

Master of Science (MS)

Other Master's Degree

If you clicked "Other Master's Degree," please specify:

Institution of Master's Degree:

Master's Field of Study:

Did you receive any graduate assistantships during your first year in grad school?

Yes

No

If you checked "Yes," please specify which one:

Teaching Assistantship

Research Assistantship

Other

Date of Master's Degree Enrollment:

Date of Master's Degree Attainment:

Have you earned a doctorate degree?*

Yes

No

If you checked "Yes," please specify which one:

Doctorate of Medicine (M.D.)

Doctor of Philosophy (Ph.D.)

Doctorate of Education (Ed.D.)

Other Doctorate

If you clicked "Other Doctorate," please specify:

Institution of Doctorate Degree:

Doctorate Field of Study:

Date of Doctorate Degree Enrollment:

Date of Doctorate Degree Attainment:

If you are no longer in grad school, please specify why you left:

Current Employment:*

Work Address:*

City:*

State:*

Work Phone:(XXX) XXX-XXXX

Position:*

Is this position an assistantship?*

Yes

No

Recent Accomplishments (publications, presentations, awards, fellowships/scholarships, personal)*

If you could tell current McNair students one thing or give them one piece of advice, what would it be?*

Would you like to receive the McNair Newsletter?*

Yes

no

Have you visited our website within the last six months?*

Yes

No

Comments:*

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Alumni Form

McNair Alumni Tracking Form