First Name

Last Name while attending NEIU

Current Last name (if different from above)

Current Address

Current Phone Number

Current Email Address

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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