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U.S. ALUMNI INTERVIEW FORM

* required information

The form below should be filled out by those who are interested in our upcoming interview session about the life and work of alumni. We will select 10 candidates to interview and film.  The short (15 min.) videotape will be show for the first time at the alumni conference.  (Note: Only selected alumni will be contacted). The registration deadline is June 10, 2009.
First Name : *
Last Name : *
Gender :
Date of Birth :
Email Address :   *
Mobile Phone :  
Current Residence (City) :
Current Residence (Country) : *
Type of Study abroad program: (scholarships, fellowship, self-finance etc) *
U.S School Attended : *
Majors : *
Minors :  
Other :
Degrees/Certificates : *
Year of Graduation :
  		*
Year of living in the U.S. :
Work Experience : *
Highlights & other activities : *
Current Career : *
Title : *
Employer/Company : *
Preferred venues/places and Time for Interviews (if selected) : *
References contact (optional information) :