| *Required field |
| Personal details |
Personal reference
(if known): |
(e.g. alpha numeric number beginning with P/M above your name on your Quad/BLC reply form) |
| Marital status: |
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| First name(s): |
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| Surname: |
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| Title: |
Other
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| Former name(s) (if applicable): |
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| Date of birth (dd/mm/yy): |
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| Address: |
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| Postcode: |
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| Telephone: |
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| Mobile: |
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| Fax: |
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| Email address: |
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| Study details |
| First qualification: |
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| College attended: |
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| Graduation year: |
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| Subject: |
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| Second degree / Other qualification: |
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| College attended: |
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| Graduation year: |
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| Subject: |
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| Free subscriptions |
| Did you receive the latest copy of the alumni magazine? |
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BLC
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Please send me OnQ, the newsletter for teachers and careers advisors
Please send me the QMUL Events leaflet
Please email me the termly Alumni e-Newsletter |
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| Empolyment profile |
Your first destination - after graduation were you: |
Employed
Seeking work
Self-employed
Further study
Retired
Volunteering
Other,
please specify:
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| Job title: |
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| Company: |
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| Date (mm/yyyy) (from-to): |
-
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Please indicate your income band:
NB. This information will be treated in strictest confidence and will not be disclosed. |
Under £15,000
£15,000 - £19,000
£20,000 - £24,000
£25,000 - £29,000
£30,000 - £34,000
£35,000 - £59,000
£60,000 - £74,000
£75,000 - £99,000
£100,000 - £249,000
£250,000 - £490,000
Over £500,000 |
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| Current employment |
| Currently are you: |
Employed
Seeking work
Self-employed
Further study
Retired
Volunteering
Other,
please specify:
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| Name of current/recent employer (if self-employed, please give us details): |
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| Occupation (e.g. PR Officer): |
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| Department: |
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Employment sector:
(e.g. advertising, education): |
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| Time in this employment: |
Start date:
End date:
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Please indicate your income band:
NB. This information will be treated in strictest confidence and will not be disclosed. |
Under £15,000
£15,000 - £19,000
£20,000 - £24,000
£25,000 - £29,000
£30,000 - £34,000
£35,000 - £59,000
£60,000 - £74,000
£75,000 - £99,000
£100,000 - £249,000
£250,000 - £490,000
Over £500,000 |
| Address of employer: |
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| Postcode: |
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| Telephone: |
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| Email address: |
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| Employment website: |
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| Other current work details (including voluntary work) |
| Organisation: |
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| Title: |
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| Start date (mm/yyyy): |
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| Employment history |
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| Can you offer to help Queen Mary? |
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| Your news |
We are pleased to receive your news for publication in the next issue of Catch-Up in Quad (up to 60 words)
Please note that Catch-Up is made available on our website.
Please tick this box if you do not wish your news to be published on the web. |
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| Activities and support while a student |
| Name of scholarship/prize received
(include year and amount please): |
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| I was a Student Steward/Class representative: |
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| I was a Student Ambassador: |
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| I went on a student placement organised by: |
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| Your network |
| Your family |
Please give details of other Queen Mary, Westfield or Barts and The London School of Medicine and Dentistry alumni or students you are related to. Please give their name, subject, college and year.
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| Your friends |
We would like to know if you have stayed in touch with your contemporaries. Please give their names and subjects studied.
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| Lost friends |
If you would like us to help you find missing friends from your College days please give as many details as possible, such as the subject they studied and years at the College. We will pass your contact details to any person(s) you name here.
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| Declaration |
Under the terms of the Data Protection Act currently in force, your data is securely held in the Alumni Relations Office and is treated confidentially. The data is available to our faculties, academic Schools and administrative departments, and is used for a full range of alumni activities, including alumni relations mailings, the promotion of benefits and services available to alumni, notification of alumni events, networking and development and for feedback on the value of our courses. If you object to the use of your data for any of the above purposes, please contact the Alumni Relations Office at alumni@qmul.ac.uk .
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