General InformationName* First Last Maiden Student ID* Please Select Your Campus Location*Please Make a SelectionKU ClearwaterKU DaytonaKU ECampusKU Flagship ResidentialKU Ft. LauderdaleKU Fort MyersKU Graduate SchoolKU JacksonvilleKU MiamiKU LakelandKU MelbourneKU NaplesKU New Port RicheyKU OrlandoKU Patrick Air Force BaseKU Pembroke PinesKU Port Saint LucieKU SarasotaKU TallahasseeKU TampaKU West Palm BeachGraduation Date* Month Day Year Major* Current Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell PhoneEmail* Enter Email Confirm Email Current Employment InformationCompany Name* Position Title* Hire Date* MM slash DD slash YYYY Supervisor Info* Full Name Position Title Company Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Company Website Work Phone*Work FaxCurrent Annual Salary* The request for salary information is for the sole purpose of tracking salary trends in various industries and determining statistical information on salary ranges. This information will be kept completely confidential.I Work* Full-Time (40 + hours/week) Part-Time (< 40 hours/week I Receive Company Benefits*YesNoSince employed here, have you been promoted?*YesNoSubsequent EducationHave you attended any other colleges since graduating from Keiser University?*NoYesName of School* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Subsequent Education Information*MajorType of Degree/CertificateEnrollment DateGraduation Date (Expected Date)Community InvolvementAre you currently involved in any community activities?*NoYesWhat organizations/community projects would you like to see Keiser University involved with?