Survey - Update My Information - Salt Lake Community College

Please update my contact information to:


	Title:
*	First Name: Required
	Middle Name:
*	Last Name: Required
	Suffix:
*	Email: Required
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
	Please check this box to receive or continue receiving periodic email updates from Salt Lake Community College
	Email Format:
	Yes, I would like to receive postal mail from Salt Lake Community College
	Keep me logged in. What's this? Remembers your login information for your convenience. Use only on trusted, private computers. Privacy Policy

Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

*	User Name: Required	5 to 60 characters
*	Password: Required	5 to 20 characters
*	Repeat Password: Required

Question - Not Required - Name(s) when attended:

Question - Not Required - Last year attended:

Question - Not Required - Graduation year:

Question - Not Required - Home Phone number:

Question - Not Required - Mobile Phone Number:

Question - Not Required - Work Phone Number:

Question - Not Required - SLCC has my permission to text me information of potential use to me:

Question - Not Required - Preferred Phone Number:

Question - Not Required - What is your preferred method for SLCC to contact you?

Question - Not Required - Please add me to the following email mailing lists:

	SLCC Alumni Newsletter, the college’s quarterly emailed update for alumni and friends of SLCC.
	SLCC College Event Updates
	SLCC Financial Planning Seminars
	SLCC Today, the college’s weekly e-newsletter

Question - Not Required - I'd like to know more about becoming more involved with SLCC:
Please make up to 3 selections from the choices below.

	Volunteering (speaking to a class, facilitating a tour of my business, etc)
	Touring campus to learn about SLCC's current priorities and efforts
	Other

Question - Not Required - If you chose "other" above, please specify:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Today's date for mobile response capture:

Month

Day

Year

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Update My Information