Alumnus Exit Survey

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General Information
Full Name:
University ID Number:
Address after graduation (Street, City, State, Zip):
Phone Number:
Secondary Phone Number:
E-Mail Address:
May we include you in our weekly e-mail distribution list?
  Yes
No
Date of Birth:
Date you entered Wesleyan:

At Wesleyan
Did you enter Wesleyan as a Freshman, or were you a Transfer Student?
  Freshman Transfer Student
Did you attend weekend or evening classes while you attended Wesleyan?
(check all that apply)

Weekend Evening
What was your major?
What was your minor?

After Graduation
Do you have a job ready for after Graduation? Yes No
If yes, then please tell us where:
Which, if any, of the following Graduate programs have you been a part of in the past?
  MED GPNA MBA COU None
Are you planning to attend graduate school in the future?
Yes No
If yes and you've been admitted, which graduate program do you plan to attend?
 

Spousal Information
Spouse's Name:
Did your spouse attend Texas Wesleyan? Yes No
If yes, what were the dates of his/her attendance?
If you and your spouse have any children, what are their names and birthdays?
 
Have your children attended Wesleyan? Yes No
Did your parents or grandparents attend Wesleyan? Yes No
If so, what were their dates of attendance?
 

Participation and Achievements
Which of the following did you participate in or achieve while attending Texas Wesleyan:
(check all that apply) Resident Life (Lived on campus)
A Wesleyan Athletics Team
A Fraternity/Sorority
The Rambler Staff
The Dean's List
Graduate with Honors
Received an Award at Awards Day
Student Government (SGA)
List any campus organizations (and offices held) or activities in which you participated:
 
Church affiliation (i.e. Methodist, etc):
Which congregation do you belong to?
Community service or organizations in which you belonged
Please list any Honors, Awards, or Publications that you have earned:

Alumni Services
Would you be interested in serving on any of these Alumni Committees and Activities?
(check all that apply) Student Recruitment
Annual Fundraiser
Reunion Committee
Career Assistance
Alumni Association
Homecoming Events
This last item is very important - If we lose contact with you over the years, list two or more relatives who would still know how to contact you (please include name, address, phone numbers & email).