Johnson Registration Form
Cornell UniversityJohnson at Cornell University

Alumni Events Registration Form

 Required fields are in red
Salutation:
First Name:
Middle Name:
Last Name:
Suffix:
Type your name as you would like it to appear on your nametag.
Please include both your first and last name, but do not include degrees - they will be added.
Name Tag:
Are you a Johnson Alumnus/Alumna? Yes No
Johnson Degree and Year:
If you have any other Cornell degrees,

Guests If you will not be bringing any guests, skip this step.
(information you have already typed will be retained.)
 
Preferred address This is my
Home Address Business Address
Address 1:
Address 2:
City:
State:
Postal Code:
Country:
If your Country is not listed, enter it into "Other Country", below.
Other Country:
Phone:
FAX:
Preferred Email:
Company:

 
Please note any dietary restrictions or special needs for yourself (maximum 255 characters):
(notes concerning your guests should go on the guest form)
 

Please indicate the events you plan to attend

Please be advised that refunds will be available up to 72 hours prior to the day of event.

Events
Johnson Club of the Middle East Networking Event -- April 3
Johnson Club of Rochester - Social Media - Why Me? -- April 23
Johnson Club of NYC - Wine Tasting Event -- April 24
8th IILM Distinguished Global Thinker Award Ceremony - New Delhi -- March 31
Johnson Club of NYC - Women's Event: Business Breakfast with Laurel Touby -- May 15
Reunion: Class of 1979 Cocktails and Dinner -- June 5
Reunion: Class of 1979 Golf Outing -- June 6
Reunion: Class of 1979 Patio Party - Lake Lunch & Refreshments -- June 6
Alumni Affairs
Johnson at Cornell
130 E. Seneca Street
Ithaca, NY 14850-4353

phone: 800 847-2082 ext. 2 or 607 255-9436
email: alumni@johnson.cornell.edu