Alumni Information Update Form

Update Your Contact Information

We need your help! Have you moved or changed jobs? We would like to hear from you and update your information.

First Name:
Middle Name:
Last Name:
Maiden Name:
Street Address:
City:
State:
Country:
Zip Code:
Telephone:
(with area code)
E-mail:
Class year:
(if NICC Alumnus)
Program/Major:
Employer:
Position:
Business Address:
Business Telephone:
(with area code)
Spouse First Name:
Spouse Last Name:
If your spouse is NICC graduate, please enter their graduation year:

Other Comments:


Would you be interested in participating in a student mentoring program?
Yes   No

Would you be interested in speaking to a class?
Yes   No