Colombo University - Faculty of Science Alumni Association of North America (CUFSAA)- Membership Survey
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. We are organizing an Inaugural get-together of alumni and well-wishers of the Science Faculty of the University of Colombo, Sri Lanka will be held on September 03-04, 2016 (Labor Day Weekend).

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.

Here is the link to the Survey to pass along to your contacts: http://goo.gl/forms/lWbRSdx7PH

Thank you for your support!

Conveners: Prof. L M V Tillekeratne and a group of fellow University of Colombo, Science Faculty Alumni

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

University of Colombo - Science Faculty Entrance
Part 01 - Your Contact Information for Membership List
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 City of Residence *
Please enter the city of residence only. Not your house number and the street address.
Your answer
9. Your State/Province of Residence *
Your answer
10. Your Country of Residence *
11. Year of Entrance to Science Faculty of University of Colombo (Your Batch) *
e.g. If you entered university in 1980, please answer 1980. Those who earned PhDs, masters, or certificates degrees from the Science Faculty, please enter the degree program and the year of entrance. Those who were in the Science Faculty staff, please include position and year.
Your answer
12. Your Year of Graduation (Your Class) *
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. Your Area of Study
e.g. Chemistry
Your answer
Part 02 - Your thoughts and ideas on what we can do together to help the Faculty of Science, University of Colombo.
Please let us know your thoughts and ideas for future activities. We are looking for long-term as well as short-term activities to pursue. We have a sizable group of Science Faculty alumni in North America with admirable resources. It is time that we put some of our resources to work. Many of our talents do not even cost money to share.

Thank you!

14. What would you like us to achieve?
Please select one or more items from the list below or add your own goals.
15. Your suggestions for future get-togethers and events for fun or fund raising
Please select one or more items from the list below or add your own suggestions.
16. Would you like to be involved with CUFSAA committees and organizing events for CUFSAA?
If, answered YES, please let us know how you can help.
Your answer
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