• Dr. Robert Brubaker, Chair
  • Department of Psychology
  • 127 Cammack Building
  • 521 Lancaster Ave. Richmond, KY 40475
  • Phone: 859.622.1105
  • FAX: 859.622.5871

Let's Hear from Alumni

We love to hear from our alumni. After a rough past couple of years in publishing the PsyQ, we want to know what you have been up to so that we can include an alumni update section in the PsyQ. Please send us your updates by filling out the form below and submitting it.



Alumni Questionnaire

Name: 
 
Telephone
 Home:
 Cell:
 Work:
 
Address:
 Line 1:
 Line 2:
 City:
 State:
 Zip Code:
 
E-mail Address:
Degree  (Please check all that apply)
   BS in Psychology
   PsyS in School Psychology		    MS in General Psychology
   MS in Clinical Psychology
   MS in I/O Psychology
 
Year First Degree was Awarded: 
     Second Degree (if applicable): 
     Third Degree (if applicable): 
 
Professional/Personal Accomplishments:
 
Can we publish this information in the next PsyQ?  Yes    No

Can we publish this information on our departmental web site?  Yes    No
 
What other kind(s) of information would you like to see on our Alumni Web Page(s)?