Project Upward Bound @ Oakland University

Welcome to the Office of the Dean of Students at Oakland University

PUB Alumni Form

Please keep us up to date on what's new in your life by completing this form once each year. If nothing has changed since the last time you completed it you can use the short version.

Personal Information
1.	Title	Mr. Ms. Mrs.
2.	First Name
3.	Middle Initial
4.	Last Name
5.	Maiden Name
6.	Last 4 digits of SSN (Social Security Number)
7.	Address
8.	Apartment
9.	City
10.	State
11.	Zip Code
12.	Country
13.	E-mail
14.	Phone - Cell
15.	Phone - Home
16.	Phone - Business

PUB Affiliation

17. PUB Affiliation Classic Upward Bound
Fine Arts Academy
Cadet Engineering Program

18. High School

19. Graduation Year (mm/dd/yyyy)

20. Number of years in PUB

21. Did you stay with PUB
through grade 12? Yes
No

22. If no, why not?

23. How did PUB influence your life?

24. Your advice to current PUB participants:

Education

25. Highest Degree Earned

26. Year (mm/dd/yyyy)

27. Area of study

28. School

29. Are you still in school? Yes
No

30. Degree Expected

31. Year Expected (mm/dd/yyyy)

Other Information

32. Current Employer (Name/City/State)

33. Job Title

34. Future career goals:

35. May we include your biography in PUB's
"Spotlight on Alumni" column in the
In Focus Newsletter?
(If Yes, please email a picture to
PUB@oakland.edu) Yes
No

36. Are you willing to participate in a
College/Career Day? Yes
No

37. Honors and awards

38. Community/Civics/Professional Involvements

39. What's new in your life that you want us to know about?

40. Are you in contact with any other OU Project Upward Bound Alumni?
If so, please list their name, a phone number, and/or email address
so we may contact them.