Were you a participant in any of the programs created by Larry Hawkins? The Office of Special Programs-College Prep is forming an Alumni Association! The goals of the Alumni Association will be to engage program participants and encourage them to support the work of the program, to participate in efforts to enhance its sustainability, and to encourage mutually beneficial relationships between the Office of Special Programs-College Prep, alumni, and the parents of alumni and current students. Membership is open to all participants. There are no dues to join.

We are in the first phase of forming the Association… gathering information about our alumni to build a directory and form a group of alumni who want to help with encouraging members to share their personal information. We want to identify OSP-CP members who participated in 1968, the first year of the program. With your help we will be successful. This survey will serve as the Alumni Contact Information Form. We ask that you make the completion of this survey a priority as well as to help us to recruit other alumni to do the same. The data we collect from you and your colleagues will help to tell our stories of success and enhance our ability to find additional funding for college preparation programs for middle and high school students. Thank you for your help and please forward this link to others in your network of OSP-CP alumni.

* 1. Contact Information

* 2. What is your birthdate:

* 3. Which OSP-CP Program were you a participant of? (Check all that apply)

* 4. Did you participate in the following activities? (Check all the apply)

* 5. High School:

* 6. Two-Year Post-Secondary Questions:

* 7. Four-year Post-Secondary Questions:

* 8. Graduate School Information:
(Please list all graduate schools and degrees you received)

* 9. Professional School?
(Please list all professional schools you have attended)

* 10. Employer Information:
Please respond to the following questions.

* 11. Optional Family Information:
Answers to this question are not mandatory.

* 12. Statement of Impact:
Participation in the program...

* 13. Are you willing to be : interviewed, photographed, and/or videotaped?

* 14. Do you have experiences you would like to share with us? If so, please use the space below.

* 15. Electronic Signature of the applicant and date.
(Type your name in the box below; it will serve as your electronic signature.)