MEDUNSA UPGRADE - University of Limpopo

UNIVERSITY OF LIMPOPO ALUMNI
SEARCH
Please help us update our ALUMNI database with current contact information,
so that we can continue to be in touch with all University of Limpopo alumni.
UNIVERSITY ALUMNI FORM:
Title: ……………………...………..…….............................…………………....
Initials: …………………..………..……….............................…………………….
First name: …………….......…..……….............................……………………..
Surname:……..…………………..………............................……………………..
Date of birth: (yyyy/mm/dd) …..……...............................……………………..
Address:…………………………..……….............................…………………….
Postal code: ……………………………….............................…………………….
Tel: (H) …………………..………..……….............................…………………….
Tel: (W)………………….………..……….............................…………………….
Cell: ………………….....………..……….............................…………………….
Email: …………………...………..……….............................…………………….
When were you at UL? (e.g. 1993 − 1996) ……….....…….................……….
Degree(s) obtained: ……….…………………..……...…............………………….
When was/were your degree (s) obtained: ……….............…………………….
Degrees obtained at other institutions (Please specify): …………………………..
……….............................………….............................................………….
Occupation:………………………...…..………........................………………….
Special achievements / honours: ……………......................…………………….
Please return the completed questionnaire to Clare-Rose Julius:
Tel: (+27) 011 791 4561 Fax: (+27) 011 791 2390 Cell: 072 545 2366
This form is available on the websit at www.dgrwriting.co.za
Postal address: P O Box 2756, Pinegowrie 2123, Gauteng, South Africa
Email: info@developmentconnection.co.za
(Photocopies are accepted)