Alumni Email Request Form
Fields marked with * must be filled in.
 
Prefix:
First Name*:  
Middle Initial*:  
Last Name*:  
Suffix:
Maiden Name: (If Applicable)
Birthday*:   (mm/dd/yyyy)
Address*:  
 
City*:  
State*:  
Zip*:  
Home Phone:
Cell Phone:
Email Address*:  
(please enter a valid email as this will be the address used to
email you the information about your new account) 
DO NOT USE YOUR OLD CAMPBELL UNIVERSITY ACCOUNT AS YOUR EMAIL ADDRESS.
YOU MUST USE AN EXTERNAL EMAIL ACCOUNT.
 

Graduation Information

Graduation Year*:  
Degree Earned:
Major:
 

Employment Information

Employer:
Title:
Employer Address:
 
City:
State:
Zip:

Additional Information

Are you married:
Spouse Name:
Is your Spouse a Campbell Alumni?
If Yes, Spouse Graduation Year:
Spouse Degree:


Note:
Requests for Campbell University Alumni email addresses may take several days to process.  Please be patient.  If you have not received a confirmation email within one week, please contact Revonda Ballard at rballard@campbell.edu or 910.893.1569