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Personal
Information
Sex:
Male
Female
First
Name:
Middle Name:
Last Name:
Nick Name:
Spouse's Full Name:
Academic Information
Program
Affiliation:
Petroleum & Natural Engineering
Mining Engineering
Mineral Processing
Fuel Science
Geo-Environmental Engineering
Industrial Health & Safety
Mineral Engineering Management
Advisor's
Name:
Penn
State Degrees:
Ph.D., Year
M.S., Year
B.S., Year
Home Information
Home
Address (line 1):
Home Address (line 2):
City:
State:
Zip Code (+ 4 digit extension):
Country:
Home Telephone (include area code or country & city code):
Home E-mail Address:
Home Page URL:
Work Information
Company
Name:
Your Title:
Company Address (line 1):
Company Address (line 2):
Company Address (line 3):
City:
State:
Zip Code (+ four digit extension):
Country:
Work Telephone (include area code or country & city code):
Fax:
Work E-mail Address:
Work Home Page URL:
Permission Information
If
another graduate of Energy and Mineral Engineering contacts
the department in an attempt to find you, do we have your permission
to release your information?
Yes
No
Additional
Comments
As
an alumni of the Department of Energy and Mineral Engineering,
we welcome your comments.
After you have reviewed your information,
press the "Send Form" button. The form will be mailed
to Rachel Altemus, Alumni Coordinator, rla7@psu.edu,
814-865-3439.
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