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“Birmingham is a cultured and vibrant city, full of quirky and popular places to visit. A social and cultural heaven”

Please complete the following form which will enable us to register you as a member of Birmingham City University Alumni Association. Membership is available to all former students of the University and its predecessor institutions. The information you provide will not only enable us to register you as a member but also enable us to develop meaningful benefits and services.

If you are a former staff member, a separate form is available to register your membership, you will find it here.

Fields shaded in grey indicate information we require in order to complete your membership. Areas not shaded are optional and do not have to be completed if you do not wish to.

Title	First Name
Middle Names(s) (if applicable)	Surname
Maiden Name	Other Aliases (if applicable)
Gender Male Female
Date of Birth

Home Address
Town/City	County
Postcode	Country
Home Telephone	Other Telephone

Email Address (email address you would like the correspondence to go to)
Marital Status	Do you have Dependants? Yes No (If yes, how old are they?)
What are your interests? (e.g. golf, football, reading, theatre, cinema et cetera)

ACADEMIC RECORD

Latest course studied : Institution studied at : Birmingham City University Birmingham Polytechnic Associated College UCE Birmingham
If associated college which one (e.g. Sutton College, Birmingham College of Art)
University ID (if known)	Faculty
Subject studied
Award received (e.g. BTEC HND, BSc (Hons))	Classification attained (e.g. 2:2, 2:1)
Year study started	Year study completed
Mode of study (e.g. Full, Part-time, Distance learning)	Campus (e.g. Perry Barr, Millennium Point)
Student accommodation lived in during study (if applicable)
Did you hold any special positions? (e.g. Student Ambassador, Union President)

Other course (if applicable) : Institution studied at : Birmingham City University Birmingham Polytechnic Associated College UCE Birmingham
If associated college which one (e.g. Sutton College, Birmingham College of Art)
University ID (if known)	Faculty
Subject studied
Award received (e.g. BTEC HND, BSc (Hons))	Classification attained (e.g. 2:2, 2:1)
Year study started	Year study completed
Mode of study (e.g. Full, Part-time, Distance learning)	Campus (e.g. Perry Barr, Millennium Point)

PROFESSIONAL DETAILS

Are you Employed Self-employed Retired Family Commitments Voluntary Work Engaged in further study Unemployed Other
What is the industry you are employed in? (e.g. Education, IT, Engineering, Consultation)
Job title	Employer
Town/City	County
Work telephone	Work email
Salary Under £15,000 £15,000-29,999 £30,000-49,999 £50,000-74,999 £75,000-99,999 Over £100,000 Prefer not to say

I am interested in the following alumni services:
Reunions	Further courses	Email newsletter	Sport Facilities
Networking	Talking to students	Career Services	Library Services
Lectures	Memorabilia	Conference facilities	Alumni Magazine

I agree that my name and address can be used by Birmingham City University for other marketing purposes within the University.

Data Protection Act 1998: Under the terms of the Data Protection Act 1998 the University undertakes to process any data collected in a responsible manner. Specifically, it will process any personal data for the purpose of administering and analysing alumni business (to include the University’s statutory Destinations Survey)*. The University will also ensure the accuracy and currency of data; documented timescales will be applied to the retention of information held in this connexion. It is your right at any time to view copies of data held by the University in relation to you. Appropriate measures shall also be taken against accidental loss or damage to your personal data, by means of permissive access to the database. The data shall not be transmitted outside the European Economic Area. Should you have any query regarding Data Protection Act issues, please contact the Information Manager, Stephen Homer (stephen.homer@bcu.ac.uk, 0121 331 5288).

* The Destinations of Leavers from Higher Education (DLHE) Survey is carried out by all Higher Education Institutions within the UK, as a study into the activities of university leavers. All information is held confidentially, and it will not be possible for any respondent to be identified from any published data.

Please remember to update your details if you move address or your employment details change. Amendments to your membership details can be forwarded to alumni@bcu.ac.uk.

Opportunities

Class notes

Alumni links

Please remember to update your details if you move address or your employment details change. Amendments to your membership details can be forwarded to alumni@bcu.ac.uk.

Birmingham City University, Perry Barr, Birmingham, B42 2SU
Main switchboard: +44 (0) 121 331 5000 Course enquiries: +44 (0) 121 331 5595