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Business Submission Form
The USI Alumni Association reserves the right to deny the posting of products and services that are inconsistent with the mission of the University of Southern Indiana and the USI Alumni Association. Please complete the new business form below to include your name and business information in the alumni online directory. All information submitted will be reviewed by the USI Office of Alumni and Volunteer Services. If you have any questions, please email alumni@usi.edu or call 812/464-1924.

Required elements are denoted by *

Personal Information
* Record Type:
New Record Update Record
* Full Name:

First Name

MI

Last Name
Maiden Name:
* First Major/Degree:

Major
Degree
Grad Year
Second Major/Degree:

Major
Degree
Grad Year

Business Information
* Your Position:
* Business Name:
- OR -
* Street Address:
* City, State, Zip:

City
State
Zip Code
* County:
* Business Phone: ex. 3175551212
Extension: ex. 191
Fax Number: ex. 8124651080
Email Address:
Website Address:
Business Description and/or Discounts Available:
* Business Category:

* Security Code: 6cpcx



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