General Information

Name:

Home Address:

City:

State: Select One ------------- US States ------------- AL, Alabama AK, Alaska AZ, Arizona AR, Arkansas CA, California CO, Colorado CT, Connecticut DE, Delaware DC, District of Columbia FL, Florida GA, Georgia HI, Hawaii ID, Idaho IL, Illinois IN, Indiana IA, Iowa KS, Kansas KY, Kentucky LA, Louisiana ME, Maine MD, Maryland MA, Massachusetts New Brunswick MI, Michigan MN, Minnesota MS, Mississippi MO, Missouri MT, Montana NE, Nebraska NV, Nevada NH, New Hampshire NJ, New Jersey NM, New Mexico NY, New York NC, North Carolina ND, North Dakota OH, Ohio OK, Oklahoma OR, Oregon PA, Pennsylvania Puerto Rico RI, Rhode Island SC, South Carolina SD, South Dakota TN, Tennessee TX, Texas UT, Utah VT, Vermont Virgin Islands VA, Virginia WA, Washington WV, West Virginia WI, Wisconsin WY, Wyoming ---------Canadian States--------- Alberta British Columbia Manitoba New Brunswick Newfoundland NW Territories Nova Scotia Ontario Prince Edwards IS Quebec Saskatchewan Yukon

Zip:

Undergraduate School: The Wharton School The College of Arts and Sciences The School of Engineering and Applied Sciences The Nursing School

Major(s):

Minor(s):

Year of Graduation:

Lifelong Email Address:
(i.e. Hotmail, AOL, @wh99.wharton.upenn.edu)

Graduate School:

Major:

Current Work Information

Company Name:

Location:

Position:

Email Address:

How long you have worked at your current company:

Previous Work Information (please include internships)

Additional Questions

Would you be interested in participating in Alumni panels on campus? Yes No

Would you like to be informed of upcoming BWUA events? Yes No

Would you like to mentor a current undergraduate? Yes No

Would you like to receive the BWUA newsletter? Yes No

Do you prefer to be contact at home or at work? Home Work