Alumni Registration | Northern College

First Name*

Middle Name

Last Name*

Name on Diploma (Example: Maiden Name, etc)

Birth Date*

Phone Number*

Email*

Student Number (if you remember)

Address

City*

Province/State

Country

Postal / Zip Code

What program/s at Northern did you complete?*

What year did you graduate?*

What campus did you attend?*

Tell us about yourself (interests, associations) and how did you hear about the Alumni Association?

What type of participation in the Alumni Association would interest you?

Participating in events
Helping to organize events
Recruiting other Alumni
Organizing class reunions
Serving as an Executive Member
Writing articles for a newsletter
Other

Are you working in a related field?*

Yes
No

Occupation / Position*

Name of Company

Work Phone Number

Confidentiality Statement The information you have provided on this Alumni Association Registration Form will be used only for the purpose of supporting the activities of the Northern College Alumni Association and Northern College.

Do you give permission to publish the above information?*

Yes
No

Alumni Communications: Please note that after submitting your Alumni Membership Registration information, you will be taken to a confirmation page. This page will provide a link to signup in order to receive email communications with the Northern College Alumni Association in accordance to Canada's Anti-Spam Legislation (CASL).