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Relationship to University (you may choose more than one) Graduate Student - current or former Staff - current or former Other Student ID Staff ID Please specify your relationship to the Uni Email address Title - None -Associate ProfessorDrEmeritus ProfessorJudgeLadyMasterMissMrMrsMsProfessorRevSirOther Please specify your title First name Middle name Surname Post nominal - None -ACAC AOAC CMGAC CSC RAN(Rtd)AC CVOAC PSMAC QCAC SC FBAAFSMAMAM ASMAM EDAM OAM RFDEDAM OBEAM PSMAM QCAM RFDAM RFD EDAM RFD QCAM SCAM, KStJAOAO JPAO OBEAO PSMAO QCAO SCAPMAS SCASMASM OAMBM APMCBECBE ACCGSJ FAICD JPCMGCSCCSC RANCSMD.D.S.DFCESMEsg.FAAFCPAFRACPFRACP FRCPAFRSFRSAIIIIIIVJPJr.M.D.MBEMCMLCMPMP JPOAMOAM BEMOAM EDOAM JPOBEOBE AOPh.D.PSMQCRFDRFD AORSMSCSr. Preferred first name Former surname Gender - None -FemaleMaleOtherPrefer not to say Date of birth Home address Suburb State Postcode Country - None -AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta and MelillaChadChileChinaChristmas IslandClipperton IslandCocos [Keeling] IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau SAR ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar [Burma]NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaSão Tomé and PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Would you like to join an alumni network?? Yes No Our alumni community stretches across the globe. Wherever life may take you after Adelaide, you can connect with fellow alumni through one or more networks. Join now by selecting the relevant boxes below (please tick as many as you like). South Australian network Adelaide University Sports Association Inc Art History and Curatorship Alumni Network Commerce Network ECIC Alumni Friends of the University of Adelaide Library John Bray Law MBA Alumni Association (MBAAA) Roseworthy Old Collegian Association Inc (ROCA) Wine Alumni Network Young Alumni Network International network Adelaide University Alumni Association Singapore Thailand Network University of Adelaide Alumni Association Hong Kong Inc The University of Adelaide Malaysia Bhd South Australian Universities Alumni Europe University of Adelaide North East USA Alumni Network China Alumni Network - Shanghai China Alumni Network - Beijing Subscribe to electronic publications Stay in touch with the latest University and alumni news through our range of publications available electronically. Please tick the relevant boxes to subscribe to any of the following electronic publications. Lumen electronic the online version of the University's alumni magazine, published twice a year Alumni eNews the University's alumni e-newsletter, published monthly The information you provide will be used for the primary purposes set out in the University of Adelaide’s Privacy Policy. Please refer to the University’s Privacy Policy for more information, including the types of other entities to which the University may need to disclose Personal Information; how you can seek access to your Personal Information held by the University and how you can make a complaint if you feel your privacy has been breached. Thank you for completing this form.
