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Queen's University

Queen's University Alumni Card Application

Card Image

* Denotes required field

Are you a member of this year's graduating class?* Yes No

Student Number: [No spaces or hyphens, e.g., 1234567]
First Name:*
Last Name:*
Mailing Address Line 1:*
Mailing Address Line 2:
Postal Code/ZIP Code:*
Telephone: [Example: 613-5336000]
Email Address:*
Confirm Email Address:*
Card Name:* Please enter your name as you would like it to appear on your card, up to a maximum of 21 characters, including spaces.

QUAA member since:* Please enter your degree YEAR here. If you have more than one degree from Queen's, please enter your first one.

[Example: 2005]

Please choose one of the following:*

I would like to pick up my alumni card on campus at the Alumni Relations office in Summerhill (Campus Map)

Please mail my card to me at the address indicated above

Further Contact:

Please note that from time to time, we may solicit your feedback for the sole purpose of enhancing the services/benefits provided to you as a Queen’s Alumni Card holder. Identifying information about you will be removed from survey results so that your privacy and confidentiality are protected.

The personal information collected on this form is collected under the authority of the Royal Charter of 1841, as amended, and the Freedom of Information and Protection of Privacy Act. The personal information will be used to send you material designed to provide you with information about Queen's University, and to keep you up-to-date on campus happenings for fundraising purposes and university advancement activities, and to facilitate answering any University-related question you may have. If you have any questions or concerns about the information collected, or how it will be used, please contact the Office of Advancement, Queen's University Kingston, ON, K7L 3N6, or by telephone at 613-533-2060, or 1-800-267-7837.

Kingston, Ontario, Canada. K7L 3N6. 613.533.2000

For general inquiries about Office of Advancement events and programs, please call our Contact Centre at 1-800-267-7837 (toll free in Canada or the US), or 613-533-2060.