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Alumni Survey

THE UNIVERSITY OF AKRON

DEPARTMENT OF POLYMER ENGINEERING

ALUMNI SURVEY

Please take a moment to complete the following survey. Please click here to print the Survey Form in the pdf format. Please click here to print the Survey Form in the word document format.

Your answers are very important to us in evaluating the success and progress of our graduates as well as to you in terms of renewing friendships, receiving future news from the department, and obtaining composite data on careers in polymer engineering.

Please note that the directory will only provide professional data about you for the purpose of networking with your colleagues – all other information requested on this survey will not be listed and will be kept in strictest confidence for internal use only by the Department.

  Dr.    Mr.    Ms.     Mrs.    Miss  ( Please check one)

  Name:

 Address:

City/State/Zip:

Country:

Home Phone:

Home E-mail Address:  

 Home Fax:

Occupation or Position Held:

Employer:

 Type of Business of Employer:

 Employer's Address:

 Employer's City/State/Zip:

 Employer's Country:

 Work Phone:

Work Fax:

 Work E-mail address:

 Current Salary (optional and strictly confidential)

< $ 20,000                                          $50,000- $59,999                                     $80,000-89,999

$20,000- $29,999                                $60,000-$69,999                                      $90,000-$99,999

$30,000 - $39,999                               $ 70,000-$79,999                                     > $100,000

$40,000- $49,999                               

     Education:

College/ University

 Degree (BS, MS, PhD)

 Major

 Year Recieved

    Current Research Interersts and/or Recent Publications (please list full citation) :

     Current Professional and Non-Profit affiliations:

      Recent Honors and Awards:

     

Name of Faculty Advisor while at University of Akron:

Are you interested in helping the Department of Polymer Engineering     

on recruitment or alumni issues:  Yes       No     Later

 

Spouse's Name:

Spouse's Occupation:

Spouse's Employer:

Is your spouse a Alumnus/Alumnas of UA:   Yes*         No

* If yes please list major and/or degree:

   

We Welcome your comments, feedback, and suggestions:

       

 

                        

Thank you for taking the time to respond to this survey. Please return to:

Sarah Thorley, Department of Polymer Engineering, 106 Polymer Engineering Academic Center,

The University of Akron, Akron, OH 44325-0301

Or log onto

www.poly-eng.uakron.edu

 

 

The University of Akron

Akron, OH 44325
Phone: 330-972-7111
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© 2013 by The University of Akron • The University of Akron is an Equal Education and Employment Institution.