MNS in Applied Chemistry

Graduate Information Form

We are excited about the work that is being accomplished in our MNS in Applied Chemistry program here at Southeast. And we are excited about the work that our graduates are doing. We want to use our program website to communicate that excitement--both to prospective new students and to our former students.

Please take a few moments to complete this information update and consent form to let us know what you are doing and give us permission to post your information on our website. We would also like to update our contact information so that we can keep in touch and possibly send you a newsletter periodically to let you know where the program is going. This information WILL NOT be used to solicit monetary donations of any kind.

Clicking the Submit button below will cause an e-mail containing the information you entered to be sent to the Graduate Committee Chairperson.

Items in RED will only be used to update contact information and will never be published in any form without your clear consent.

First name: Last name:

Maiden name (if different):

Street address or PO Box: Apt. No.

City: State: Zip:

Telephone: () - E-mail address:

Where are you employed?

What is your job title?

What's new in your life? Did you get married, have a baby, get a new job, move into a new home? Tell us what is exciting in your life:

I give my permission for the Chemistry Department to post my name, place of employment, and job title on the MNS program website

I give my permission for the Chemistry Department to post my e-mail address on the MNS program website so that former classmates may contact me if they wish.

I give my permission for the Chemistry Department to post all or part of my response to the question "What's new in your life?" on the MNS program website so that my classmates can find out what I've been up to.

MNS in Applied Chemistry Home

Last modified Tuesday September 28, 2004 by Jim McGill