Brock Alumni Employee Program

Celebrating alumni that work together
Do you work for a company that employs several Brock Graduates? Tell us a bit about your alumni colleagues and we’d love to send you some swag to ‘Brockify’ your work space. Your organization will also be entered into a draw for a chance to win a pizza party hosted by Brock Alumni! Please fill out the form below and we will be in touch with more details.
Host Name * Required
First Last
Brock ID (if known)
Grad Year * Required
Program
Company/Organization * Required
Job Title * Required
Employment Start Date - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Work Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Email * Required
Work Phone * Required
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Personal Email
Home Phone
Please provide the names and emails of alumni co-workers that you know of * Required
For more information please email alumni@brocku.ca
Email
This field is for validation purposes and should be left unchanged.