To Our Dear Alumnus,

This survey aims to gather relevant data about you as our

graduate to help us in track of Alumni records. Kindly
answer all the questions given below. Thank you for your
cooperation and support.

Name:______________________________________________________
FIRST MIDDLE LAST (MAIDEN – for married women)

Present
Address:___________________________________________________
___________________________________________________________

Birthday: _______________ Place of Birth:__________________

Tel. No(s)/ Cell phone: ______________E-mail_______________

Civil Status: _______________ Citizenship: ________________

Year graduated from SMCM: ___________ Level_______________

Highest Educational Attainment:____________________________

School Attended After Graduation

Name of School Year Graduated Awards/ Recognition

________________ __________________ ___________________
________________ __________________ ___________________
________________ __________________ ___________________
________________ __________________ ___________________

Significant Achievements

Political / Civic Career Social

________________ __________________ _____________

________________ __________________ _____________

Present Affiliation / Membership

Name of Organization Position Year Duration

___________________ _______________ ___________________

___________________ _______________ ___________________

Employment Record (if any)

Position Employed Company/Institution

(Present to Past) (From – To)

______________________ ________________ ________________

______________________ ________________ ________________
______________________ ________________ ________________
______________________ ________________ ________________
______________________ ________________ ________________

Children presently studying at

Name Grade/Year Awards/Recognition

_________________ _________________ ___________________

_________________ _________________ ___________________
_________________ _________________ ___________________
_________________ _________________ ___________________
_________________ _________________ ___________________
_________________ _________________ ___________________
_________________ _________________ ___________________
_________________ _________________ ___________________

Any relatives who graduated from

Name Relationship Year Graduated Tel. No. /

Cell phone /

E–mail Address
____________ _____________ ______________ _____________
____________ _____________ ______________ _____________
____________ _____________ ______________ _____________
____________ _____________ ______________ _____________
____________ _____________ ______________ _____________

Signature of the Alumnus: _________________________________

Date: _____________________________________________________