Alumni Card Request Form

Take advantage of your status as a Western alumna or alumnus and request your free Western Alumni Card today!

Please allow 10 – 15 business days to receive your alumni card in the mail. If you need your card sooner than that, sign up for Purple Perks and download the app to access your digital alumni card.

*First name:
*Current last name:
*Last name at the time of graduation:
Student number (optional, 9 digits):	[My student number is less than 9 digits. What do I do?]
*Degree:
*Year of graduation:
*Email:
Phone number:
Phone type:
*Please confirm how your name should be printed on your card:

Mailing Address - please provide the address to which your Western Alumni Card should be mailed.
*Street 1:
Street 2 (Apt or Unit #):
*City:
*Prov/State:	Enter your province\state\region below
*Country/Region:
Postal/ZIP code:
I consent to the information provided above, to be used to update my Western alumni record. I understand that updates to my alumni record may result in my receiving communications from Western’s Alumni Department unless I have otherwise opted out of such communications. Please read Western's Privacy Policy if you wish to learn about how the University protects and uses your information.
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