Name      

Address  

City       State       Zip  

Telephone  

Email  

High School Attended    

Graduation Year     

Are you currently attending or a graduate of a college, university, or vocational school?  yes  no

If so, what school are you attending or a graduate of?  

If you are a post high school graduate, what was your major and degree type?     

If you are a student, what is your major?  

Are you currently employed?   yes   no

If employed, name of employer.  

What are your long term career plans?  

What do you consider MEPI's impact on your life to be?  

What grades were you a member of MEPI?      thru  

Additional comments  

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Thank you for taking the time to fill out our survey and good luck in your future endeavors