Alumni Questionnaire (Civil Engineering, USM)
Here at the School of Civil Engineering, Universiti Sains Malaysia (USM), we make every effort to keep in touch with our alumni community. By completing this questionnaire, you can make sure you stay up to date with all the latest news from the School of Civil Engineering, USM. The form should only take a few minutes to complete, and will help us to ensure you receive information on those areas of the University that interest you most.

Your cooperation is very much appreciated and if you have any queries, please contact us via email/tel./ fax to:

Alumni PPKA
School of Civil Engineering,
Engineering Campus,
Universiti Sains Malaysia
14300 Nibong Tebal,
Pulau Pinang, Malaysia

Email: alumnippka@gmail.com
Tel: +604 599 6204 (Pn Zeida Shuheera Shamsuddin) / 6271 (Assoc. Prof. Dr Fatimah Denan)
Fax: +604 599 6906

Webpage: http://civil.eng.usm.my/
Facebook: https://www.facebook.com/sce.usm/

Sincerely,
Alumni Team PPKA

The following information is strictly for University purposes and will not be shared with any third party.

Personal Details
Title
Your answer
Full Name *
Your answer
Gender *
Date of Birth (DD-MM-YYYY) *
MM
/
DD
/
YYYY
Preferred Address
Your answer
Preferred Email *
Your answer
Preferred Tel.
Your answer
Qualification from USM
(*tick more than one if needed)
Qualification *
Required
Year of Graduation *
Your answer
Work Details
Have you registered as a member of the Board of Engineers Malaysia (BEM) (only for local alumni)
Current Employment Status *
Job Title *
Your answer
Organisation Name *
Your answer
Work Address *
Your answer
Company / Organisation Sector *
Your answer
Your Interests
Core Strategies of the Programmes/Activities at the University
Tick more than one if needed
Supporting the School of Civil Engineering, USM
Please contact me with more information about programs/activities projects at the School of Civil Eng. via :
Getting Involved (tick more than one if needed) *
Required
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