Alumni Membership Form

Stay connected, join the Alumni Association today!

First Name:  
Last Name:  
Middle Name:

Maiden Name:

Birthdate (MM-DD-YYYY):  

Street Address:  
Address (cont.):
City:    
State: Zip:  
 
E-Mail:

Education Background

Did you graduate from NIC?   

Major:

Degree Earned (if applicable):





Transferred to or later attended: