First Name

Last Name while attending NEIU

Current Last name (if different from above)

Preferred Pronoun(s)

Current Address

Current Phone Number

Current Email Address

Social Media Handles (Facebook, Instagram, Twitter, LinkedIn, TikTok)

Additional Educational History

Current business information/field

Other information/notes (i.e. past involvement in NEIU student organizations or clubs, awards received, LinkedIn profile, or news articles)

Spouse/Partner First Name

Spouse/Partner Last Name

Spouse/Partner Email Address

Spouse/Partner Phone Number

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