Membership Application for Xerox Alumni Association

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Members of Xerox Alumni Association must have been employed by Xerox Corporation. Members agree to respect the privacy and personal data of all listings in the member database and directory. Members receive access to our Networking Directory of hundreds of ex-Xerox colleagues and can list their Web site on our Member Sites page.

Please complete the following so that we may update our database with your data and return it with your check for $10 to: Xerox Alumni Association, C/O Kay Donovan, 735 Bentwater Circle #204.   Naples, FL, 34108

Name: _________________________________Spouse's Name:_______________________________

Home Address:______________________________________________________________________

City: _______________________________    State: ______ Zip:______________________________

Home Phone:  (______)_________________ Business Phone: (______)_________________________

Fax: ___________________________ E-Mail address:______________________________________

Current Company: (if applicable)________________________Position:_________________________

Company Product/Services:____________________________________________________________


Start Date: _______ Hiring Division: __________ Hiring location:_____________________________

Separation/Retirement Date: ______ Last Division: _____________ Departure location:____________

Functional Area (Marketing, Sales, Human Resources, etc.)                                                                   

This is a member-run organization and we can use your help!  

[  ]  I will contribute information to the Web site. 
[  ]  I would like to know more about a leadership position.

   If you know someone who is not already a member of the Xerox Alumni Association and whom you feel we should contact, please list name(s) and email address(es) below.


Your membership will be confirmed via e-Mail at the address noted above at which time you will receive your password to access your personal data and other membersí information. You are responsible for maintaining your contact information in the database. You are encouraged to use bulletin boards and other Web site networking features to share information that you feel will be of general interest to the membership of Xerox Alumni Association.

Thank you for your membership in Xerox Alumni Association!