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Personal data

Salutation

Mr.

Ms.

Mrs.

Title

Surname*

Birth name

First name*

Date of birth*

Nationality

Private address

Street / house number*

Place of residence*

Postal code*

Country*

Telephone

E-mail*

Business address

Company / Employer

Department

Street / house number

City

Postal code

Business telephone

Business e-mail

Homepage

Job / Position

Fields of activity

Information about your stay at the TU Clausthal

At the TU Clausthal, I

studied

graduated

lectured

worked

Study period 1

Period (from/to)*

Department / degree programme*

Main focus

Graduation

Institute

Study period 2

Period (from/to)

Department / degree programme

Main focus

Graduation

Institute

Working hours

Period (from/to)

Institute / Department

Position

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Declaration of consent*

I agree to the storage and use of my personal data within the framework of the Clausthal University of Technology Alumni Network in accordance with the applicable data protection regulations for the purpose of maintaining contact with alumni and for processing the user relationship resulting from the registration. I agree that I may receive information about Clausthal University of Technology, be contacted and invited to events and that my data may be forwarded within the university for the purpose of alumni work.

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