UCR Alumni Association
Board of Directors Application
Applicant must be a graduate of UCR and a member of the UCR Alumni Association.
Please feel free to attach a current resume.
Date:
Full Name:
Class Year:
Name on student records:
Address Preference:
Residence
Business
Residence Address:
City:
State:
Zip:
Residence Phone:
Fax Number:
Business Name:
Business Title:
Business Address:
City:
State:
Zip:
Business Phone:
Fax Number:
Work Email:
Use this email
Personal Email:
Use this email
Degrees Received:
Institution:
Degree:
Major:
Year:
Institution:
Degree:
Major:
Year:
Institution:
Degree:
Major:
Year:
Undergraduate/Graduate Activities (clubs, honors, offices held):
University involvement since graduation:
Personal Activities:
Community Activities:
Honors, achievements, awards:
Why would you like to serve on the UCR Alumni Association Board of Directors?
Areas of interest/expertise (check all that apply)
Which board committees are of interest to you? (check all that apply)
What special qualities would you bring to the Alumni Association?
May we use your application information in our alumni publications?
YES
NO
Signature:
Date:
Mail complete application to:
Nominations Committee
UCR Alumni Association
University of California
Riverside, CA 92521-0110
or send via fax to: (951) 827-3186
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