UT Foundation
One of the University's important tasks is to maintain current information on our alumni, friends and other important constituents. Please take a few minutes to update your personal information so we can provide you with better service.

Use this form to send us changes in your address, employment, other information, request a number of free publications, or submit information for lost alumni.

Thank you for helping us keep in touch.
What is your relationship with The University of Toledo or The Medical University of Ohio?
Check all that apply: I am a University of Toledo graduate.(including the College of Law)
I am an MCO/MUO graduate.
I attended either UT or MCO/MUO.
I am the parent of a student.
I am a friend of the University but did not attend.
I am a current or former employee of the University.
Name
Prefix (Mr., Mrs., Ms., Dr., etc.):
First name:
Middle name:
Last name:
Nickname:
Maiden name:
Personal Suffix (Sr., Jr., II, III, etc.):
Professional Suffix (M.D., Ph.D., etc.)
Personal
Date of birth (mm-dd-ccyy):
Birth Country
Gender: Male Female
Marital status:
Spouse/significant other:
Children (names, birthdate, age, etc.):
Other family members who attended UT:
Social Security number: (Our site is secure. This will not be shared.)
Mailing Preference
Preferred address for correspondence: Home Work/Business
Home address and phone
Address:
City:
State/province:
Zip/postal code:
Country:
Phone:
Cell phone:
Fax:
Internet at home
E-mail:
Personal web address/Home page:
Employment and business
Job title:
Occupation:
Company name:
Work address:

City:
State/province:
Zip/postal code:
Country:
Phone:
Cell phone:
Fax:
Internet at work
E-mail:
Business web address/Home page:
Academic Achievements
Undergraduate class year
Undergraduate school:
Undergraduate degree:
Undergraduate major:
Undergraduate minor:

Advanced degree class year:
Advanced degree college:
Advanced degree :
Advanced degree major:
Advanced degree minor:

Preferred class year:
Other degree information:
Medical Residency
Hospital/Medical Center of Residency
Medical Specialty of Residency
Residency Years
Current medical Specialty
Areas of interest at UT
Alumni Activities
Theatre
Cultural Events
Music
Art Exhibitions
Lecture Series
Personal Development
Life-long Learning Opportunities
Athletics especially (name the sport)
Continuing Medical Education
Mini Medical School
(This is a five session evening program highlighting current developments in areas of broad medical interest such as heart disease, cancer and healthy aging.)
Other, (Please specify)
Involvement at UT
Describe any activities or organizations in which you participated while you attended UT or MCO/MUO.
Request publications or information
You can request any of these publications or obtain other information. 

Check as many as apply.
Alumni Association Membership Information
Annual Fund Information
Planned Giving Information
Giving Club Information
Foundation Annual Report
Cornerstones eMagazine
Toledo Alumni eMagazine
Other
Comments, questions, observations
Please give us your feedback:
Submit this form
     

(Please do not submit the same page more than once.
Doing so could result in multiple charges to a credit card.)

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For questions about this webpage, please call our office at 419.530.7730 or email us at utfoundation@utoledo.edu