2012 Alumni Return to Serve Registration Form
**All participants should have graduated ON or BEFORE MAY 2010.*** REGISTRATION DEADLINE: OCTOBER 5, 2012
First and Last Name:
Name while attending WSSU*:
Ex. A female's maiden name.
Street / City / State / Zip (Career Development Services will add you to our mailing list to keep you abreast of our events, and new developments).
Ex. Bachelor of Science
Name of School:
Ex. Winston-Salem State University
Ex. Master of Arts in Education
Name of School/College/University:
Please select one of the following:
Other (please specify below)
If "other", please specify:
Name of Employer:
Your Job Title:
Briefly describe your job duties and responsibilities:
Please select which session(s) you will attend and if you plan to attend the luncheon:
Return to Serve - Session A
BREAKFAST 8:00 a.m. - 9:15 a.m. and Classroom Visitations 9:30 a.m. - 12:15 p.m.
I will participate in Session A
I will not participate in Session A
Return to Serve - Session B
Luncheon by Invitation Only; MUST participate in Session A or C to attend luncheon.
I will participate in Session B
I will not participate in Session B
Return to Serve - Session C
2:00 pm - 3:00 pm Panel Discussion/TC 207
I will participate in Session C
I will not participate in Session C
Return to Serve - Sessions A, B, and C
A = Breakfast & Class Visitations, B=Luncheon, and C=Panel Discussion
I will participate in all three sessions. (A, B, and C)
I will not participate in all three sessions, but I have indicated my choices above.
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