Dear Purdue Alumni and Friends:

The following questionnaire has been designed to solicit your feedback and collect your ideas about the possibility of establishing a Purdue Alumni Club in (Location). Thank you in advance for taking a few minutes to complete and return this questionnaire by (Date) . We look forward to receiving your comments, and remain convinced that forming a club would promote Purdue University and the Purdue Alumni Association through involvement and support of local community activities and would provide opportunities for networking among alumni, friends and students.

Do you agree that a Purdue Alumni Club should be formed in (City/Town) ?

[ ] Yes         [ ] No

Listed below are several types of programs and activities that have been successfully sponsored by other clubs and/or might be offered by a Purdue Alumni Club of Please check those which interest you. Use the space provided to write in any other suggestions.

[ ] Annual social

[ ] Local TV viewing of athletic events

[ ] Family-style picnic / barbecue

[ ] Golf outing

[ ] Back-to-school send-off with new and returning students

[ ] Community service work

[ ] Tent / display at local fairs

[ ] Block ticket purchase for the club at a Purdue athletic event

[ ] Joint activity with other Purdue Alumni Club(s) – specify _________________

[ ] Joint activity with other local Big Ten alumni club(s) – specify _________________

[ ] Raise funds to award scholarship(s) to deserving local Purdue students

[ ] Other: ____________________________________________________________

If this club is formally organized, how often would you expect it to hold meetings or events similar to those listed above? Check one:

[ ] once per year

[ ] four times per year

[ ] twice per year

[ ] five times per year

[ ] three times per year

[ ] more than five times per year

How often do you believe you might attend these club-sponsored meetings or events? Check one:

[ ] once per year

[ ] four times per year

[ ] twice per year

[ ] five times per year

[ ] three times per year

[ ] more than five times per year

Are you interested in serving on a steering committee to help establish this club?

[ ] Yes       [ ] No

Name: __________________________________

School / Year: __________________________________

Address: __________________________________

Home or cell phone: (______) _________________

E-mail address: __________________________________

Work phone: (______)_________________

Are you and/or your spouse currently members of the Purdue Alumni Association? If “Yes”, specify name and school / year.

Self: [ ] Yes       [ ] No

Spouse: [ ] Yes      [ ] No

Please return to:

Name:

Address:

Phone:

Email: