Chapter Webpage Survey

1. First Name:

2. Last Name:

3. Preferred Email address:

4. Phone number (optional):

5. What is your affiliation with Northeastern University?

6. What year did you graduate from Northeastern?

7. Age range?

8. Gender?

9. In what state do you live in?

10. In what city/town do you live in?

11. In what industry do you work?

12. What type of events are you interested in attending?

13. What is the best way to inform you about events?

14. Are you interested in helping to plan events for your local alumni chapter?

15. Are you interested in mentoring a co-op student working in your area?

16. Are you interested in organizing Northeastern alumni within your company?

17. Do you have a suggestion for an alumni event or program?