Alumni Form

The McNair office would like to know what you have done since undergraduate school. The data will be used to write the Department of Education annual report. Some responses, with your approval, may be printed in upcoming newsletters and/or the webpage. Please take a few moments to complete and submit it via email when you are done.

Section 1: Current Information

Email Address:
Name (first, m.i., last):
Maiden Name (if different):
Street Address:
City     State   Zip
Home Phone:      Work Phone:
Date you completed your undergraduate degree: Month: Day: Year:
What was your final undergraduate GPA (on a 4.0 scale)?
Please choose the response that applies to you:

If you are NOT currently in graduate school:
When were you LAST enrolled in school? Month: Year:
Name of institution LAST enrolled in:
What was your department?
What was your major?

Reason Not Enrolled:

Section 2: Post-baccalaureate Degree Information

How many post-baccalaureate degrees have you completed? (please mark all):       
Masters     PhD     MD      JD     
Other (Please specify: )    
What is the highest post-baccalaureate degree that you received?  
When did you receive your highest post-baccalaureate degree? Month: Day: Year:
If you are currently not in school, do you have plans to return?  
Yes  No (If "yes," please go to Section 3 - Otherwise, skip to Section 4.)
If you plan to attend graduate school, when do you expect to apply?
(approx. date): Month Year:

Section 3: Graduate School Information

I am attending/planning to attend (name of institution):
in City: State:
I am working/planning to work on my (check all that apply):
Masters       PhD       MD       JD       Other Please specify:
This is/will be my:   1st   2nd   3rd   4th   post-baccalaureate degree.

Major Field of Study:

For those of you currently in graduate school please fill out the information below applicable to your current program of study:
I expect to graduate on: Month Year:
I expect to take/have taken the preliminary exam on: Month Year:
I expect to take/have taken the qualifying exam on: Month Year:

Section 4: Employment Information:

Name of Employer:
Employment Address:
Position Title:

Section 5: Other Information:

Awards, Honors, Promotions received:

Publications (citations):

Leadership Roles:


Additional comments/suggestions (e.g. for McNair newsletter and/or website):

You may when done, or if you want to start over.

Thank you for helping us update our files! Please keep us informed of any news you would like to share with other McNair members. To read our latest newsletter or learn more about current events with the McNair program at UW-Madison, please check out our Web site at: http://www.wisc.edu/McNair/