_____ Yes, I want to be a member of the UAB Alumni-Admissions Program to help UAB recruit academically gifted and diverse students!!!
Title ______Name ____________________________________________
UAB Graduation Year(s) ____________Major(s) ____________________
Address_____________________________________________________
City____________________ State_______________ Zip______________
Home Phone (___) ________________ Office Phone(___)______________
Business Name________________________________________________________
Business Address______________________________________________
City____________________ State_______________ Zip______________
Occupation (Job Title) __________________________________________
E-mail Address________________________________________________
Please list extracurricular activities you were involved in as a UAB student (i.e. committees/clubs, sorority/fraternity, Ambassadors, honor societies, Honors Program, athletics, etc.): ___________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
Please list three high schools in your area:1) __________________ 2) __________________ 3) ________________
What important aspects of UAB would you stress most to prospective students? ___________________________________________________________ ____________________________________________________________
Please check the following activities that interest you:_____ Host reception in your home for prospective or accepted students
_____ Attend reception for prospective or accepted students in your area
_____ Attend local college fairs
_____ Telephone prospective and accepted students
_____ Write prospective and accepted students
_____ Mail in local newspaper clippings of prospective students
Additional comments or suggestions you have regarding the Alumni-Admissions Program:1) __________________________________________________________
2) __________________________________________________________
3) __________________________________________________________
Please mail or fax this form to:
UAB Undergraduate Admissions Office
Alumni Admissions Program Coordinator
HUC 260, 1530 3rd Ave S.
Birmingham, Alabama 35294-1150
Fax: (205) 975-7114
Phone: (205) 934-8221 or (800) 421-8743
undergradadmit@uab.edu