Alumni Profile Form

This form is intended to seek information on alumni who have engaged with National Fellowships and Scholar Programs that we may use to write up a small feature story, profile, or provide to other areas seeking to do the same.

Name *

First

Middle

Last

Pronouns

Name while at USC

USCID

Email while at USC

Personal Email *

Cell Phone *

I am a... *

Top Scholar Alum

National Fellowship Alum

What was the most impactful experience you had as a Top Scholar?

What was the greatest benefit you gained from the Top Scholar community?

Please list the National Fellowship award(s) you received, status and year

How did your national fellowship experience influence where you are and what you are doing now?

Graduation Year *

Degree *

Majors and minors *

Employment(1)

Job Title

Employer

Dates

Employment(2)

Job Title

Employer

Dates

Employment(3)

Job Title

Employer

Dates

Are you or have you pursued additional education? Yes No

School(1)

Program of study and degree (if relevant):

School(2)

Program of study and degree (if relevant):

Have you had any major life changes you would like to share (gotten married, moved, etc.)?

Take a moment to reflect on your time at USC. What experiences (inside and beyond the classroom) had a meaningful impact on you? Was there a moment that stands out as a "defining moment" in your life?

Was there a particular person or people whose mentorship or guidance made a significant impact--how so?

Attach a File: Please upload a photograph of yourself. A strong horizontal would be great!

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Caption for photo.

Release of Information and Photograph: I authorize and consent to USC using the information I provide on this form and the photo I upload may be used in full or in part to create a profile, spotlight or article on me to be used on the internet and/or print. *

By checking this box, I agree to the statement above

If you would like to be tagged on social media if/when we highlight you, please indicate your handles.

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National Fellowships and Scholar Programs

Alumni Profile Form

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