Alumni Registration Form
Personal Information
First name *
Your answer
Middle name
Your answer
Last name *
Your answer
Email address *
Your answer
Verify email address *
Your answer
Permanent Residence
City *
Your answer
State *
If "Other," please specify.
Your answer
Zip Code *
Your answer
Current Residence, if different from above
City
Your answer
State
If "Other," please specify.
Your answer
Zip Code
Your answer
NSLI-Y Program
(if you participated in multiple NSLI-Y programs, list your first program first)
Year *
(Program years begin with the summer programs. For example, fall 2010 and spring 2011 participants should select "2010-11"; summer 2011 participants should select "2011-12".)
Duration *
Language *
Location *
Did you participate in a second NSLI-Y Program?
If yes, please enter the information requested above for the second program
Your answer
NSLI-Y Alumni Association Regions
Please select up to three regions on which there are currently NSLI-Y Alumni Representatives and with which you would like to stay connected.
Region- 1st preference
Region - 2nd preference
What additional regions or cities would you like to see represented, if any?
Your answer
Where are you now?
Current status *
If "Other," please specify.
Your answer
Academic institution, if applicable
Please include your most recent academic institution (undergraduate or graduate) if applicable.
Name of Institution
Your answer
City
Your answer
State
Country
Your answer
Degree and Major/Field
Your answer
Graduation Year
Your answer
Previous academic institutions
Please list previous academic institutions, if applicable.
Your answer
Employment, if applicable
Job title
Your answer
Employer
Your answer
City
Your answer
State
Country
Your answer
Field
Your answer
Share Your Achievements!
Please use the space below to share your academic, professional, and personal achievements since your completion of the NSLI-Y program. Be sure to highlight further engagement with your NSLI-Y language, host country, and/or culture. The NSLI-Y Administrative staff may contact you to follow-up on details.
Your answer
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