Alumni Network Registration Form

The LGBT Resource Center would like to connect with lesbian, gay, bisexual, transgender, queer and ally alumni interested in being part of an LGBTQ Alumni Network.

Through our Alumni Network, we hope to connect old friends, help new friendships develop and keep NIU's LGBTQ and Ally Alumni involved with current LGBT happenings at Northern.

The Alumni Network will also offer opportunities for professional networking. Alumni can also support current LGBTQ students at NIU through scholarship and mentoring programs.

To get involved and to get information about the NIU LGBT Alumni Network, please fill out and submit this confidential form to the Lesbian, Gay, Bisexual, Transgender Resource Center.

*Required

Contact Information

*Name:   *E-mail:
*Home phone: Cell phone: Work phone:
*Home Address:
Mailing Address:

Degree Information

*Most recent graduation year: *Most recent degree earned:
Other graduation degrees/years:
*Area(s) of study:

Additional Information

*Please list any LGBT related organizations or activities you were involved in:
(example: LGBT Resource Center staff, Prism member/officer, Ally program participant, etc.)
*Did you receive an LGBT Studies Certificate?:



May we contact you, with notice, for opportunities to interact with other NIU LGBT Alumni or current students?
(LGBT Alumni panels, NIU Alumni events, guest speakers, Pride Letter columns, etc.)


The LGBT Resource Center does not make our Alumni data visible online or in print.