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ALUMNI ASSOCIATION

Membership Registration

Thank you for your interest in the Valencia Alumni Association. Simply complete the following application to become a member.

Information about membership eligibility can be found at Valencia Alumni Association Membership.

All information is kept confidential. If you have questions while filling out your application, contact the Alumni Relations office at 407-582-3417... or alumni@valenciacollege.edu.

Your Personal Information (all information kept confidential!) *Required information fields
Title * Title Required	First Name *	Middle Initial	Last Name *
Maiden Last Name	Gender	Date of Birth
Primary Phone Type * Required Field.	Primary Number *	Secondary Phone Type	Secondary Number
Email *	Valencia ID#	Home Address *	APT / Suite / Other
City/Town/Province & Postal Code *		State * State or Province Required.	Country
US Zip Code *

Your Valencia Information
Degree *	AS AAS AA BS Tech. Cert. (TC) Please Choose One
Year graduated, expected graduation year or year last attended
Major
Secondary Degree	AS AAS AA BS Tech. Cert. (TC)
Secondary Degree Graduation Date, expected graduation year or year last attended
Secondary Major Interest
How did you hear about us?	If other, Specify:

Your Network

Area of Networking Interest

Alumni Architecture Chapter

The Association of Honors Alumni

Alumni Bridges Program

Alumni Culinary Arts

Alumni Dental Hygiene

Alumni Hospitality and Tourism

Alumni Nursing Program

Alumni Radiography

Alumni Respiratory Care

Awards/scholarships?

Your Alumni Interests

Area of interest

After-hours Networking Committee

Alumni Chapter Development Committee

Alumni Scholarship Committee

Alumni Travel Program Committee

Diversity Committee

Fundraising Committee

Leadership Development Committee

Membership Development Committee

Special Event Committee

Volunteer Committee

Other

Your Comments
Include news about jobs, employer press releases, promotions or accomplishments, awards, special events that you would like to share. You may include further education, professional certifications beyond Valencia College, listing the college name, degree, major, graduation year. (200 character maximum)
Notes
Enter any notes here. Please add any comments or suggestions. (200 character maximum)
By clicking on submit you will receive an automatic e-mail response confirming your membership.

Valencia College provides equal opportunity for educational opportunities and employment to all. Contact the Office of Human Resources and Diversity for information.