MSU Alumni Association ::.. Club Request Form for MSU Student Information

*Items with are required.**
Club Name: *
Purpose / Event: *
If for an event, specify date and fill out event notification form: *	Month Day Year
Requested by: *
Day Telephone: *
Evening Phone: *
Your Email Address: *
Alternate Email Address:
Currently Enrolled Students:	Term Year of Student Enrollment
New Grads w/ conferred degrees as of:	Term Year of Student Enrollment (Going back no more than one year)
New Grads with or without conferred degrees as of:	Term Year of Student Enrollment (Going back no more than one year)
Transfer/New Admits for:	Term
File Format: *	Excel Text (comma delimited)
Zip Code Range: *	From: To:

Files will be sent directly to your E-mail account.

Please note: This information is considered CONFIDENTIAL by Michigan State University, and this information can only be used in conjunction with official business related to the Michigan State University Alumni Association and its officially chartered Regional Clubs and Constituent Groups. It is expressly forbidden to give this information to other parties or sell this information to other parties.

Questions? Email or call us at (877)MSU-ALUM (678-2586)