Alumni Card Request Form

All fields marked with an asterisk (*) are required.

Your Contact Information (Use this section to fill out your current preferred contact information.)

*First Name:
Nickname:
*Last Name:
*Primary Email (Recent grads must use another email that is not your pdx.edu address):
*Street Address:
Apt/Unit:
*City:
*State:
*Zip:
*Country:
*Phone Number:
*Phone Type:
*Ok to receive an occasional text message:
Yes! I want to receive emails with special benefits, discounts, event invites and announcements for alumni members

Your PSU Information (Use this section to fill in information from your time at PSU. This will help us locate your record in our system.)

PSU Email:
PSU ID:
*PSU Degree and Major:
*Class Year:
Former Name (if different while attending PSU)