Alumni Status Update Form

You completed your ICM program with so much more than a great education. Participate, contribute and reap the benefits of being an ICM Alumni. Connect with former classmates or fellow graduates in your industry or area of profession.

Please fill out the form to let us know how best we can serve you.

Name Name * First Last
ICM ID or U of M number *
Preferred Email *
Please provide a phone number you can be reached on
Where do you currently live?

Where do you currently live? In Winnipeg In Canada (outside Winnipeg) Outside Canada
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
What is your current status? *

What is your current status? Current UM student UM graduate Current student at other institution Graduate of other institution
Faculty of Study? ex. Mechanical Engineering *
What is the name of the institution and faculty? ex. University of Winnipeg Faculty of Arts
What is your current profession?
What is your term and year of graduation ex. Fall 2022

It is still relevant even if it is a future date
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.