Colombo University - Faculty of Science Alumni Association of North America (CUFSAA)- Membership Form
Hello!

This form is to collect membership data of the alumni of the Science Faculty of the University of Colombo, Sri Lanka living in North America (USA, Canada, and Mexico). Your responses are secure and will be used only for the purposes and objectives of this Association.

Our plans are to organize additional activities in the future. Please fill out this survey to keep informed about CUFSAA activities through newsletters, bulletins, and emails.

Please forward the link of this survey to your fellow Science Faculty Alumni and encourage them to fill out the survey and become CUFSAA members.

Here is the link to the Survey to pass along to your contacts: https://goo.gl/forms/nBOt2H0KOMxDc7Q73

Thank you for your support!

CUFSAA Executive Committee

[Expected time to complete the survey is less than 5 minutes.]

CUFSAA Membership Form
Let us know how to get in touch with you so that we can include you in our membership list.

Thank you!

1. Your Title *
Choose all that apply.
Required
2. Your First Name *
Your answer
3. Your Last Name *
Your answer
4. Your Preferred Email Address *
Your answer
5. Your Alternate Email Address (if any)
Your answer
6. Your Preferred Phone Number *
Please include area code and type. e.g. (330) 123-4567 (Home).
Your answer
7. Your Alternate Phone Number
Please include area code and type. e.g. (330) 123-4567 (Mobile).
Your answer
8. Your Postal Address *
Please enter your house number, street address, city and postal codes.
Your answer
9. Your State/Province of Residence *
Your answer
10. Your Country of Residence *
11. Nature of Your Association with the Faculty of Science of the University of Colombo, Sri Lanka. *
e.g. Tell us if you were a staff member, undergraduate student, graduate student, etc..)
Your answer
12. Duration of your association. *
Please let us know the beginning and ending year of your association. e.g. If you graduated from the university in 1984, please answer 1984. Those who earned PhDs, masters, or certificates degrees from the Science Faculty, please enter the degree program and the year of graduation.
Your answer
13. References
Please name any CUFSAA member OR current or former Colombo University Science Faculty academic staff member we may contact as a reference, if necessary.
Your answer
14. Additional Remarks
Any skills, interests, expertise that could be useful to CUFSAA?
Your answer
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