Alumni Registration Form

Please fill out the following registration form and click on Submit.

Last Name*
Maiden Name
First Name*
Employer Name
Business Address
City
State
Zip Code
Country
Phone
Mobile
Fax
Email*
Employer Type
Primary Practice Area
Law School
Law School Graduation Year

Home Address
City
State
Zip Code
Country
Phone
Fax
Email

Former Dechert Office(s)
Year Started	(yyyy)
Year Left	(yyyy)
Dechert Practice Area
Position at Departure

Would you like to be included in our Alumni Directory?	YesNo
If yes, which contact information can we include?	HomeBusinessBoth
Please specify any information you do not want included:
Would you like to receive our alumni newsletter?	YesNo
If so, how would you prefer to recieve the newsletter?	EmailMail
Please list any personal or professional news that you would like us to include in the newsletter:
Would you be interested in writing an article for the alumni newsletter?	YesNo
Would you like to be invited to alumni events?	YesNo
Are you interested in attending CLE presentations?	YesNo
If so, what are your areas of interest?
To which address would you like mailings sent?	HomeBusinessBoth
At which email address would you like to be contacted?	HomeBusinessBoth
We want and value your input. Please give us your comments and suggestions to help make our alumni program a success.