Alumni Registry - Academia Cotopaxi

Dear Alumni,

We are excited to reconnect with you and learn about your journey.

Through this form, we aim to gather updated information about your professional endeavors and explore opportunities for collaboration. Whether you're interested in mentoring students, offering internships, giving talks, or participating in school events, your involvement can make a significant impact.

Thank you for taking the time to fill out this form and for your continued support of our school community.

Name(Required)

First Last

Class of:(Required)

Personal Email(Required)

Phone(Required)

Current Address(Required)

Street Address City State / Province / Region Country

Academic info

University (undergrad)

University (master)

University (PhD)

Major chosen(Required)

Current Job Title:(Required)

Current Employer:(Required)

Industry/Field:(Required)

LinkedIn Profile (if applicable):

Please provide any additional details on how you would like to collaborate:

Do you have any suggestions or feedback for the school?(Required)

What would you want the AC alumni program to propose to you?(Required)

Do you want to share with the AC community your journey as a proud cougar?(Required)

It would be featured on LinkedIn, Instagram, Facebook and the Alumni section of the webpage.

Yes

No

Do you agree to be contacted by the school regarding collaboration opportunities?(Required)

Yes

No

Would you like to receive updates, invitations and newsletters from the school?(Required)

Yes

No

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