Chancellor’s Fellowship Alumni Update Survey Chancellor’s Fellowship Alumni Survey First Name * Preferred First Name * Middle Name Last Name * Previous Last Name (Maiden Name) * Biography: The fellowship community would like to get to know you! Tell us a bit about who you are, what you do, and what you enjoy. We encourage information both on your professional career and your personal trajectory. Current Home Address Street City * State * Postal Code * Country * Home Phone Cell Phone Personal Email Address Preferred Email Address * LinkedIn Facebook Are you currently employed? * Current Employer Name Current Employment Title Employer Postal Code FELLOWSHIP UPDATES: Is there anything you would like to share with the fellowship? It could be professional, personal, within your fellowship community, or your community at large. This could include publications, promotions, patents, awards, new family members, new cities, or other personal/professional goals achieved. News is published annually to the members of the fellowship. SPEAKING OPPORTUNITIES: We are looking for alumnae to present to current fellows once or twice a semester. Is this something you are willing/able to do? Talks could be on a variety of topics, from your current research/career position, your personal trajectory, a professional development workshop,etc. We are open to ideas and seek to make these events an opportunity for alumni and current fellows to interact and engage! Please let us know what types of information we may share and with whom. Check all that apply. For your NAME, with whom may we share this information * Current Fellows Alumni Outreach Chair (Current Fellow) Fellowship Alumni Fellowship Website None – Do not share Please let us know what types of information we may share and with whom. Check all that apply. For your BIOGRAPHY, with whom may we share this information * Current Fellows Alumni Outreach Chair (Current Fellow) Fellowship Alumni Fellowship Website None – Do not share Please let us know what types of information we may share and with whom. Check all that apply. For your EMAIL ADDRESS, with whom may we share this information Current Fellows Alumni Outreach Chair (Current Fellow) Fellowship Alumni Fellowship Website Share data in aggregate only None – Do not share OTHER FEEDBACK: We appreciate comments and feedback from the community. Please let us know your thoughts. Thank you! Please let us know what types of information we may share and with whom. Check all that apply. For your GEOGRAPHIC LOCATION, with whom may we share this information * Current Fellows Alumni Outreach Chair Fellowship Alumni Fellowship Website Share data in aggregate None – Do not share If you are human, leave this field blank. This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit