UGA LGBT Alumni Group Form

University of Georgia LGBT Alumni Group

Thank you for your interest in the alumnae/i group! We are in the process of updating our membership directory. We would like your contact information so we can keep you informed about news and events. We would also like to make a directory so our members can keep in touch. However, we want to respect your privacy. We will never disclose our membership lists with any other organizations.

Please complete the information below even if you have completed the form below (we want to make sure we have up-to-date information). If you prefer, you may print out this form and mail it to: John W. Lynch, 2425 Dooley Drive, Box 137, Decatur, GA 30033.

Check out the new Alumnae/i News page! If you have updates, please mail them to Michael Shutt at lgbt@uga.edu.

Please select how you would like us to treat your information:

I want my contact information to be accessible by members of the UGA LGBT Alumni Group.
I want my contact information to be kept confidential and limited to only those in the alumni group who need it to keep me informed.

Name:

Mailing Address:

Phone Number(s):

Email Address:

Years spent at UGA/Athens (e.g., 1990-94):

Degree(s) received at UGA (include year):

Occupation:

Position Title:

Company:

I am... (check all that apply)

an alumnus/a of UGA
a former student of UGA (but never graduated from UGA)
a current student of UGA
a current or former faculty member at UGA
a current or former staff member at UGA
not directly affiliated with UGA
other (please explain):

Select your areas of interest below: (check all that apply)

I would like to help plan events for the alumni group.
I am a member of the UGA Alumni Association.
I am interested in attending events in Athens.
I am interested in attending events in Atlanta.
I am interested in advertising my business through this network.

At present, we envision the organization having five main functions. Please rate how interested you are in each function. If you have ideas for what else the group can do, please use the comment box at the end of the survey.

Keeping in touch with friends from UGA:
Social events (tailgating, happy hours, potlucks, etc.):
Professional networking:
Updates on the progress of LGBT related issues at UGA:
Giving back to and supporting the LGBT community at UGA:

Do you have any comments, questions, or ideas for the alumni group?