Survey

Alumni Profile Questionnaire

J.H. Cohn is proud to announce the launch of our J.H. Cohn Alumni Network. This group is designed to facilitate ongoing relationships with Firm alumni and current employees and partners, provide professional education programs, and communicate the latest Firm news, updates, and alerts. We invite all former employees to please complete the one page form below to be added to our alumni database.

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1. Personal Information

Personal Information First Name
Middle Initial
Last Name
Maiden Name

2. Personal Information

Personal Information Home Address
Address 2
City/Town
State
ZIP
Personal Phone Number

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3. Preferred Email Address

Preferred Email Address

4. Additional Email Address

Additional Email Address

5. If you were not employed by J.H. Cohn, but an employee at one of the firms that combined with J.H. Cohn, please specify the predecessor firm name below

If you were not employed by J.H. Cohn, but an employee at one of the firms that combined with J.H. Cohn, please specify the predecessor firm name below

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6. Office You Worked In

Office You Worked In Eatontown, NJ

Farmington, CT

Glastonbury, CT

Lawrenceville, NJ

Long Island, NY

Los Angeles, CA

Metro Park, NJ

Newark, NJ

New London, CT

New York, NY

Roseland, NJ

San Diego, CA

Springfield, MA

Stamford, CT

White Plains, NY

Woodland Hills, CA

Other Office

7. Office Managing Partner at Time of Employment

Office Managing Partner at Time of Employment

8. Date of Hire and Departure (Note: Please enter 1 in the DD field)

	MM		DD		YYYY
Start Date	Date of Hire and Departure (Note: Please enter 1 in the DD field) Start Date Month	/	Day	/	Year
End Date	End Date Month	/	Day	/	Year

9. Title at Departure

Title at Departure

10. Current Employer Information

Current Employer Information Company Name
Current Job Title
Company Address
Address 2
City/Town
State
ZIP

11. Current Industry

Current Industry

12. Company Size

Company Size Less than $2 million

$2 million to $10 million

$10 million to $25 million

$25 million to $50 million

$50 million to $100 million

$100 million to $250 million

$250 million to $500 million

Over $500 million

13. On a scale of 1 to 4, please rate the following types of Alumni programs, with 4 being the most interested you are in a program.

	1	2	3	4
Networking	*On a scale of 1 to 4, please rate the following types of Alumni programs, with 4 being the most interested you are in a program. Networking 1	Networking 2	Networking 3	Networking 4
Professional Education (seminars, webinars, etc.)	Professional Education (seminars, webinars, etc.) 1	Professional Education (seminars, webinars, etc.) 2	Professional Education (seminars, webinars, etc.) 3	Professional Education (seminars, webinars, etc.) 4
Social Events (charity, reunions, etc.)	Social Events (charity, reunions, etc.) 1	Social Events (charity, reunions, etc.) 2	Social Events (charity, reunions, etc.) 3	Social Events (charity, reunions, etc.) 4
Keeping abreast of Firm news, technical and industry alerts, etc.	Keeping abreast of Firm news, technical and industry alerts, etc. 1	Keeping abreast of Firm news, technical and industry alerts, etc. 2	Keeping abreast of Firm news, technical and industry alerts, etc. 3	Keeping abreast of Firm news, technical and industry alerts, etc. 4

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1. Personal Information

2. Personal Information

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3. Preferred Email Address

4. Additional Email Address

5. If you were not employed by J.H. Cohn, but an employee at one of the firms that combined with J.H. Cohn, please specify the predecessor firm name below

*
6. Office You Worked In

7. Office Managing Partner at Time of Employment

8. Date of Hire and Departure (Note: Please enter 1 in the DD field)

9. Title at Departure

10. Current Employer Information

11. Current Industry

12. Company Size

13. On a scale of 1 to 4, please rate the following types of Alumni programs, with 4 being the most interested you are in a program.

14. How did you hear about the J.H. Cohn Alumni Program?

15. Please provide any additional comments

*1. Personal Information

2. Personal Information

*3. Preferred Email Address

4. Additional Email Address

5. If you were not employed by J.H. Cohn, but an employee at one of the firms that combined with J.H. Cohn, please specify the predecessor firm name below

*6. Office You Worked In

7. Office Managing Partner at Time of Employment

8. Date of Hire and Departure (Note: Please enter 1 in the DD field)

9. Title at Departure

10. Current Employer Information

11. Current Industry

12. Company Size

13. On a scale of 1 to 4, please rate the following types of Alumni programs, with 4 being the most interested you are in a program.

14. How did you hear about the J.H. Cohn Alumni Program?

15. Please provide any additional comments

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1. Personal Information

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3. Preferred Email Address

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6. Office You Worked In