Foundation: Alumni Registration Form

The information we collect through this web site will be used only to identify former students of Wilson Community College.  This information will not be shared or used in a way that could be harmful or detrimental to the people involved.

Required information is indicated by the red asterisk *.

Please fill out and submit the form below or you can download and print the Alumni Form and mail it to:

Wilson Community College
P.O. Box 4305 • 902 Herring Avenue
Wilson, NC 27893
Attention: Alumni Chair Debbie Williams

Name
) * *
Nickname Wilson Community College Alumni
  mm/dd/yyyy
  Male Female
 
 
,   ,
 
 
*
*May we publish your name as an alumnus? Yes No

OPTIONAL INFORMATION

Program Area

(check all that apply)
 

Continuing Education

Curriculum
  Year(s) Attended   Year(s) Attended
 
  
Affliliation
 (check all that apply)
  Degree Graduate (Graduation Year)
  Diploma Graduate (Graduation Year)
  Certificate (Completed)
  Former Student
  Current Student
  Area(s) of Study
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