IIT/Alumni Association

Directory Registration / Submit Class Notes Form

The following form can be used to register for the online directory, update your directory information, or send us your news / class notes.

Required fields are marked by an (*)

If you are registering for the online directory your username and password will be sent to you in email within 48 hours.

Do you have an Alumni ID#:	[?]

First Name*:
Middle Name:
Last Name*:
Maiden Name:
Title:	Suffix:
Gender:	Male Female
Birth Date:	(mm/dd/yyyy)
Marital Status:
Spouse Name:
Home Information
Home address*:
City*:
State*:
Zip*:
Country:
Home phone:
Home fax:
Home e-mail*:
Business Information
Position:
Organization:
Division or unit:
Business address:
City:
State:
Zip:
Country:
Business phone:
Business fax:
Business e-mail:

What is your preferred mailing address? Home Business
Educational Information
Degree(s)*:
Graduation Year(s)*:
Major(s)*:
While I was at IIT, I was involved in the following activities:

Please register me for the Online Directory