Wednesday, March 10 2010
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Alumnibeta*
Membership Form
To help us to develop services and communications which are of interest and value to you, please spare a few moments to complete this form:
Personal Details

Name  
Mobile Number  
Home Address  

Study Details

Degree  
Department  
Year Graduated  

Employement Details

Current Employment Status  
Please give your present employment details or former if you have retired.
Job Title  
Company Organisation  
Address Line 1  
Address Line 2  
Address Line 3  
City / Town  
Postal Code / Zip Code  
Work Phone  
We will send your temporary password to your email
Email Address  
Confirm Email Address  
All data is securely held in the CELTECH College Alumni Office and will be treated
confidentially and with sensitivity for the benefit of CELTECH College and its members.
The data is available for CELTECH College educational, social and charitable purposes only
and to agents contracted by the School for particular alumni-related projects which may contain ann element of direct mail.