Alumni - Vaal Triangle Campus

Alumni Association Form

The Vaal Triangle Campus invites you to join the Alumni Association by filling in your details and pledge below.

Please note: All data are handled with confidentialty according to the policy of the NWU.

Language preference: *

Title: *

First names: *

Surname: *

Maiden names:

Marital status: *

Student no (if possible):

Date of Birth: *

ID No: *

Passport No:

Country: *

Years on campus (e.g. 1991-1994): *

Qualificatios (e.g. certificate, degree(s) obtained): *

Residence on Campus: *

Occupation: *

Other:

Home telephone number:

Work telephone number:

Mobile number: * *

Fax number:

E-mail address: *

PO Box:

Suburb:

City/Town:

Country:

Postal code:

Street address: *

Suburb: *

City/Town: *

Country: *

Postal code: *

I need more information about: *