1.	Last Name*

2.	Last Name as a CNU Student (if different from above)

3.	First Name*

4.	CNU ID Number

5.	Current Email Address*

6.	CNU Graduation Date

7.	Mailing Address (Street)

8.	Mailing Address (Apartment, Floor, Suite, etc.)

9.	Mailing Address City

10.	Mailing Address State
	-- None --ALALAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

11.	Mailing Address Zip Code

12.	Mailing Address Country

13.	Primary Phone Number

14.	What best describes this number?
	Home Phone    Cell Phone    Business Phone    Preferred Contact Phone

15.	Which best describes your primary activity?*
	-- Please Select --Full Time EmploymentFull Time Graduate SchoolFull Time Volunteer/ServiceStill SeekingOther