Name:

Birth Date:

Address:

City:

State/Province: -Please select- Foreign Alabama Alaska Alberta Arizona Arkansas British Columbia California Canal Zone Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Labrador Louisiana Maine Manitoba Maryland Massachusetts Michigan Micronesia Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Foundland New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming Yukon Territories

Zip Code (or Post Code):

Country:

Phone:

Email:

Spouse/Partner Name:

Children's Names and Birth Dates:

Occupation:

Current job title:

Employer Name:

Employer Address:

Do you think Naropa should form an alumni association with a separate board of directors? (An association with a board of directors would be the "voice of the alumni". It would assist the Alumni Office in building the alumni program and reaching out to our graduates.)
Yes
No

Do you think Naropa should charge dues to be an active alumnus/a?
(Dues would be used to provide more programs, events and services for alumni and Naropa)
Yes
No

What, if anything, would you expect in return?

How often should Naropa publish an alumni directory?

Please tell us what kinds of articles you would like to see included in Naropa! Magazine, e.g. class notes, updates on campus and faculty, calendar of events, etc.:

How often do you think Naropa! Magazine should be published?

What kinds of reunions would you like? (Check all that apply)
Reunions by class year
Reunions by degree or program
Cluster reunions (i.e. classes of 1980 thru 1985, 1990 thru 1995 held together in 2005)

What kinds of reunion activities would you like? (Check all that apply)
social
educational
family activities
picnic/barbecue
more formal dinner
other

Where would you like the reunions held?

What time of year would you like reunions to be held?

How would you rate the overall quality of your Naropa education?
Very poor
Poor
Fair
Good
Excellent

Would you recommend a Naropa education to others?
Yes
No

In what ways are you interested in contributing to Naropa? (Check all that apply)
Contribute financially
Teach or lead a workshop
Become a mentor to current students
Assist in recruitment of students, i.e. attend Naropa recruiting events in your area,
       speak with prospective students or parents, etc.
Plan a meeting and event in your area
Host and/or speak at events
Become part of the Naropa network that would help alumni find jobs
Start or assist with an alumni chapter in your area
Other

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