宅男研究所 Alumni Update Form

Use this form to update your contact information or to enter a Class Note for the next issue of Forever宅男研究所 magazine.

Personal Information
Name Name Title First Last Suffix
Maiden Name (if applicable)
Major(s)

List your major(s) while at Eastern.
Class Year(s)

Let us know the year(s) you graduated from 宅男研究所. Include multiple years if you received more than one degree.
Primary Email

The email you would like to be contacted at by 宅男研究所.
Secondary Email (if applicable)
Personal Web Site
Home Address Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Home Phone - ### - ### ####
Mobile Phone Mobile Phone - ### - ### ####
Spouse's Name Spouse's Name Title First Last Suffix
Spouse's Maiden Name (if applicable)
Spouse Information Including Class Year(s)

If your spouse is also an almna/us of 宅男研究所, please include his or her grad year(s).

Please use this field to indicate any information you would like to update regarding marital status.
Business/Career Information
Business/Workplace Name
Title/Position
Business Address Business Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Business/Workplace Website
Keep in Contact with 宅男研究所
Class Note

If you have a photo or other information to send with your class note, please email it to us.

Include information for Class Notes, the section of the alumni magazine that tells other alumni what you are doing in your career and/or personal life.

宅男研究所