Contact Information

First Name:

Last Name:

Class:

Address (1):

Address (2):

City:

State:

Zip:

Country:

Email:

In which PBHA program(s) did you participate as an undergraduate?

How did your volunteer work at PBHA affect your overall undergraduate experience?
Do you feel it changed you as a person? If so, in what way?

Did the time you spent at PBHA influence your life after college? How? (e.g., did
you choose a career different from the one you had planned to follow before PBHA?)

Have you participated in any public service activities since PBHA? Which ones?

PBHA would like to create a strong organization for alumni/ae:

• to interact, share what they are doing, and possibly explore ways of continuing to work together on public service tasks.
• to support PBHA so that it continues to be a strong and independent organization by providing opportunities like internships for students.

What kinds of services and programs might characterize a PBHA Alumni Association?

Would you be willing to participate in a PBHA Alumni Association? If so, what activities 
would you personally like to see a PBHA Alumni Association undertake?

Please feel free to make any additional comments here.

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We thank you for sharing your thoughts with us about PBHA - past, present, and future. Please take an additional moment now to let us know how you would like us to make use of your information (e.g., quotes for newsletters, Web site, other public relations materials; PBHA alumni/ae directory; PBHA database).

You may use my responses without obtaining permission.
You may use my responses without obtaining permission only for a PBHA alumni/ae directory. For any other materials (newsletters, Web site, brochures), you must obtain my permission.
You may use my responses only with my permission.
You may use my responses only to update the PBHA database.

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