Niagara College Canada

Full Name*:

Former Surname (when in school):

Niagara College Student Number:

Program Name(s) and Graduate Year(s)*:

Previous Mailing Address
Street / Apt # / City / Province / Country / Postal Code:

Current Mailing Address (all fields mandatory)

Street Address / Apt Number*:

City*:

Province/State*:

Country*:

Postal / Zip Code*:

Home Phone Number*:

Contact Phone Number: (if different from home number)

Email Address*:

Present Employer

Present Employer Mailing Address
Street / Apt # / City / Province / Country / Postal Code:

Business Phone Number: (and extension if applicable)

Business Fax Number:

Present Position:

The In Touch Newsletter is published two times annually and is available electronically on the web site via a PDF Download.

However, you may indicate if you wish to receive printed copy mailings of the In Touch Newsletter.

Do you wish to receive print copies of the In Touch Newsletter via Canada Post Mail? *
Yes | No

Alumni may request a permanent Niagara College Alumni Identification Card. This card is durable, imprinted with your name and never expire. Cards will be ordered through our supplier two times a year (October and April) and distributed via postal mail to the address provided.

I wish to order a Niagara College Alumni Identification Card? *
Yes | No

If further explanation is required, please include these details in the optional comments box below. (example: charge of surname due to marital status, etc.)

Please use the following text area to submit any additional comments: