With this form, you may provide, change, or update information about yourself and your career, education, family and volunteer availability. The information will be sent to the Alumnae Relations Office.

Confidentiality Statement:
Alumnae names, addresses, and biographical information are entrusted to the alumnae relations office by each individual alumna and are released to alumnae only for the purpose of volunteer efforts on behalf of Hollins. This information is protected and confidential.

   It is understood that, in releasing this information, the intent is to use it for noncommercial, personal purposes only with Hollins alumnae and classmates.

   Use of the names, addresses, or other information released to a volunteer for any multiple mailing without the consent of the alumnae relations office is prohibited. An alumna's contact information may be shared with a classmate who requests it for legitimate personal use, unless the alumna has requested that information not be shared with anyone.

   No part of any confidential alumnae information may be reproduced or transmitted in any form or by any means electronic, mechanical, photocopied, or otherwise without the consent of the Hollins alumnae relations office.

[ *  ] indicates required information for all updates. We cannot process your update without this information.
Undergraduate name used as a student:
*
Class year:
*
Last name at graduation:
*
* Are you responding to an alumnae survey that you received in the mail?
Yes No
Biographical Information:
Current last name:		Preferred first/nickname:
Preferred name for Hollins mailings: (Ms. Jane Doe, etc.)		Marital status:
		Please choose: Single Married Widowed Divorced Partnered
Birthdate: (mm/dd/yyyy)
/ /
If married, do you wish to retain your undergraduate last name?		Combined mailing name: (if married)
Yes No
Current address: (include street, city, state, zip, country)		Former address: (if submitting an address change; please include street, city, state, zip, country)
Date new address will be effective:
Telephone number: (include area code)		Is your phone number unlisted?
- -		Yes No
Seasonal address: (include street, city, state, zip, country)		At seasonal address:
		From (mm/dd): To: (mm/dd):
Seasonal telephone number: (include area code)		Is your seasonal telephone number unlisted?
- -		Yes No
* E-mail address to which you would like your Hollins correspondence sent. If you aren't providing an e-mail address, please leave default.		Indicate whether this e-mail address is:
		Residential Business
Career Information:
Employer name:		Position/Title:
Employer category:		Status:
Please choose Agriculture & Natural Resources Architecture Arts & Entertainment Business & Administrative Services Communications Construction Education & Training Engineering & Technical Financial Services Government & Public Administration Health Services Homemaker Hospitality & Tourism Human Services Legal & Protective Services Life Sciences Manufacturing Non-Profit Physical Sciences Recreation Social Sciences Technology Transportation & Distribution Other		Full Time Part Time Retired
If other, please specify:		Job category:
		If responding to a survey, please refer to the codes on the back of the letter. If you do not have the codes, please call 1-800-TINKER1.
Does your company participate in a matching gift program?		Would you be willing to advise students on your career?
Yes No		Yes No
Would you be willing to sponsor a Short Term Internship?
Yes No
Employment address: (include street, city, state, zip, country)		Business telephone number: (include area code)
		- -
Educational Information:
Name of institution or professional school: (other than Hollins)		Type of degree: (B.A., M.A., Ph.D., etc.)
Field/Major:		Date degree received:
Name of institution or professional school: (other than Hollins)		Type of degree: (B.A., M.A., Ph.D., etc.)
Field/Major:		Date degree received:
List additional degrees in the comments section below:
Spouse/Partner Information:
Last name:		First name:
Date of marriage:		Prefix: (Mr., Ms., Dr., etc.) Suffix: (Jr., III, M.D., etc.)
Employer name:		Position/Title:
Employer category:		Status:
Please choose Agriculture & Natural Resources Architecture Arts & Entertainment Business & Administrative Services Communications Construction Education & Training Engineering & Technical Financial Services Government & Public Administration Health Services Homemaker Hospitality & Tourism Human Services Legal & Protective Services Life Sciences Manufacturing Non-Profit Physical Sciences Recreation Social Sciences Technology Transportation & Distribution Other		Full Time Part Time Retired
If other, please specifiy:		Would your spouse/partner be willing to advise students on their career?
		Yes No
Job category:		Does your spouse's/partner's company participate in a matching gift program?
If responding to a survey, please refer to the codes on the back of the letter. If you do not have the codes, please call 1-800-TINKER1.		Yes No
Employment address: (include street, city, state, zip, country)		Business telephone number:
		- -
Name of institution or professional school:		Type of degree: (B.A., M.A., Ph.D., etc.)
Field/Major:		Date degree received:
Name of institution or professional school:		Type of degree: (B.A., M.A., Ph.D., etc.)
Field/Major:		Date degree received:
List additional degrees in the comments section below.
Child Information:
Name: (First, Middle, Last)		Gender:
		Female Male
Birthdate: (mm/dd/yyyy)
/ /
Name: (First, Middle, Last)		Gender:
		Female Male
Birthdate: (mm/dd/yyyy)
/ /
Name: (First, Middle, Last)		Gender:
		Female Male
Birthdate: (mm/dd/yyyy)
/ /
Volunteer Information:
If you are not a current Hollins volunteer, would you consider becoming one?		Would you be willing to serve as an Alumnae Admissions Representative?
Yes No		Yes No
		Would you be willing to serve as a Reunion Gifts Chair for your class?
		Yes No
Would you be willing to serve as a Class Fund Chair?		Would you be willing to serve as a Class Reporter?
Yes No		Yes No
Would you be willing to serve as a local area chapter chair?		Would you consider volunteering for local/regional activities?
Yes No		Yes No
Would you be willing to help with your class reunion?		Would you be willing to house students or alumnae? If yes, please check all that apply:
Yes No		Overnight During January Short Term During the summer
Additional Information:
Do you have any relatives that attend(ed) Hollins?		Is Hollins in your will?
Yes No		Yes No
If yes, please list names, relationships and class year:		Would you like information about how you may benefit both yourself and Hollins by planned giving?
		Yes No
Comments: