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MUAA Board Nomination Biography Form

Your interest in the Alumni Association Board of Directors is
greatly appreciated. Please complete the biographical data form
to provide information for the ballot.

Thank you.

Use the Tab Key to move to next field.

If you have difficulty submitting this form, please copy and paste into an e-mail and send to sutton11@marshall.edu or print out and fax to (304) 696-2299.


Enter your last name:      

Enter your first name:      

Enter your middle name:  

Enter your maiden name: 

Class Year:       
  

Degree, if applicable: 
  

 Years Attended: 

Street Address:  
  

Apartment Number:  

Box Number:  

City:  
 
 County:
   

State: 
  

Zip Code:  
 
Your home phone:  
  
 
 E-mail address:  
 
Last 4 numbers of Social Security Number:  
 
 Place of Birth:  
 
Date of Birth:  

Employer:

Employer Street Address:

Employer City:

Employer State:

Employer Zip:

Business Phone:

Years served on board previously (list dates):
 

Areas of personal interest:
 

Civic groups and offices held. Please list all pertinent information to
assist the nomination committee. A maximum of five groups/offices
would be listed on the ballot. Please list in order of preference:
 

When completed:


 
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    Marshall University Alumni Association - One John Marshall Drive - Huntington, WV 25755
    Phone: (304) 696-2901 or (800) 682-5869 - Fax: (304)696-2299 - E-mail: alumni@marshall.edu
  
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