duqalumniupdate.com
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12.150.27.29
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URL:
https://duqalumniupdate.com/PSSurveyApp.php?s=1&contact_id=81180&hash=D0JMPBT7&mid=1653217443.cBeb17e339.39208%40duqalumniup...
Submission: On May 23 via api from CH — Scanned from DE
Submission: On May 23 via api from CH — Scanned from DE
Form analysis 3 forms found in the DOM
https://www.duq.edu/du-search
<form id="header-search-form" class="header-search-form" action="https://www.duq.edu/du-search" role="search">
<div>
<label for="site-search" class="hide-for-small-up">Search</label>
<input type="text" id="site-search" class="site-search" name="terms" value="Search">
</div>
</form>POST CuSurveyApp.php
<form method="post" action="CuSurveyApp.php" enctype="multipart/form-data">
<input type="hidden" name="s" value="1">
<div class="SurveyTitle h2">Survey</div>
<div class="SurveyGroup SurveyGroup-2">
<div class="container SurveyGroupTable SurveyGroupTable-2">
<div class="row form-group">
<div class="SurveyHeader">Here is the <b>contact information</b> we have on record for you and your household. We use this information for mailings, invitations, and donation acknowledgments.<br></div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_4" class="col-form-label"><br>Title:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][4]" value="">
<input type="text" id="q_2_4" name="q[2][4]" size="10" value="" class="form-control " title="Title - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_5" class="col-form-label">Enter your FIRST NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][5]" value="">
<input type="text" id="q_2_5" name="q[2][5]" size="25" value="Deirdre" class="form-control " title="Enter your FIRST NAME - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_6" class="col-form-label">Enter your PREFERRED FIRST NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][6]" value="">
<input type="text" id="q_2_6" name="q[2][6]" size="25" value="" class="form-control " title="Enter your PREFERRED FIRST NAME - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_7" class="col-form-label">Enter your MAIDEN or LAST NAME at Graduation (if applicable):</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][7]" value="">
<input type="text" id="q_2_7" name="q[2][7]" size="25" value="" class="form-control " title="Enter your MAIDEN or LAST NAME at Graduation (if applicable):">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_8" class="col-form-label">Enter your LAST NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][8]" value="">
<input type="text" id="q_2_8" name="q[2][8]" size="25" value="Kinsella" class="form-control " title="Enter your LAST NAME - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_9" class="col-form-label">Enter your PREFERRED FULL NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][9]" value="">
<input type="text" id="q_2_9" name="q[2][9]" size="35" value="Deirdre Kinsella" class="form-control " title="Enter your PREFERRED FULL NAME -">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_12" class="col-form-label">Enter your primary CLASS YEAR:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][12]" value="">
<input type="text" id="q_2_12" name="q[2][12]" size="10" value="1996" class="form-control " title="Enter your primary CLASS YEAR - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_11" class="col-form-label">Is your spouse/partner also an alumnus/a?</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][11]" value="">
<select id="q_2_11" name="q[2][11]" class="form-control " title="Is your spouse/partner also an alumnus/a?">
<option value="">Select a value...</option>
<option value="31" selected="">No - Spouse or Partner is not an Alumnus or Alumna</option>
<option value="30">Yes - Spouse Partner is Alumnus or Alumna</option>
</select>
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_2_13" class="col-form-label">If your spouse/partner is NOT an alumnus/a, would you like them to be included on our communication to you, including for acknowledgement purposes?</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[2][13]" value="">
<select id="q_2_13" name="q[2][13]" class="form-control " title="If your spouse/partner is NOT an alumnus/a, would you like them to be included on our communication to you, including for acknowledgement purposes?">
<option value="">Select a value...</option>
<option value="33">No - I do not want my spouse/partner included in future communications</option>
<option value="34">Yes - I want my spouse/partner included in future communications</option>
</select>
</div>
</div>
</div>
</div>
<div class="SurveyGroup SurveyGroup-3">
<div class="container SurveyGroupTable SurveyGroupTable-3">
<div class="row form-group">
<div class="SurveyHeader"><b>Household</b></div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_3_15" class="col-form-label">Spouse Title:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[3][15]" value="">
<input type="text" id="q_3_15" name="q[3][15]" size="10" value="" class="form-control " title="Spouse Title - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_3_16" class="col-form-label">Enter your SPOUSE FIRST NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[3][16]" value="">
<input type="text" id="q_3_16" name="q[3][16]" size="25" value="" class="form-control " title="Enter your SPOUSE FIRST NAME - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_3_17" class="col-form-label">Enter your SPOUSE PREFERRED FIRST NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[3][17]" value="">
<input type="text" id="q_3_17" name="q[3][17]" size="25" value="" class="form-control " title="Enter your SPOUSE PREFERRED FIRST NAME - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_3_18" class="col-form-label">Enter your SPOUSE MAIDEN or LAST NAME at graduation (if applicable):</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[3][18]" value="">
<input type="text" id="q_3_18" name="q[3][18]" size="25" value="" class="form-control " title="Enter your SPOUSE MAIDEN or LAST NAME at graduation (if applicable) - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_3_19" class="col-form-label">Enter your SPOUSE LAST NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[3][19]" value="">
<input type="text" id="q_3_19" name="q[3][19]" size="25" value="" class="form-control " title="Enter your SPOUSE LAST NAME - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_3_20" class="col-form-label">Enter your spouse PREFERRED FULL NAME:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[3][20]" value="">
<input type="text" id="q_3_20" name="q[3][20]" size="35" value="" class="form-control " title="Enter your spouse PREFERRED FULL NAME - ">
</div>
</div>
</div>
</div>
<div class="SurveyGroup SurveyGroup-4">
<div class="container SurveyGroupTable SurveyGroupTable-4">
<div class="row form-group">
<div class="SurveyHeader"><b>Preferred Mailing Address</b></div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_22" class="col-form-label">Address Line 1:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][22]" value="">
<input type="text" id="q_4_22" name="q[4][22]" size="50" value="239 Niagara Point Dr" class="form-control " title="Address Line 2 - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_23" class="col-form-label">Address Line 2:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][23]" value="">
<input type="text" id="q_4_23" name="q[4][23]" size="50" value="" class="form-control " title="Address Line 2 - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_24" class="col-form-label">Address Line 3: </label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][24]" value="">
<input type="text" id="q_4_24" name="q[4][24]" size="50" value="" class="form-control " title="Address Line 3 - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_25" class="col-form-label">City:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][25]" value="">
<input type="text" id="q_4_25" name="q[4][25]" size="25" value="Erie" class="form-control " title="City - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_26" class="col-form-label">State:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][26]" value="">
<input type="text" id="q_4_26" name="q[4][26]" size="5" value="PA" class="form-control " title="State - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_27" class="col-form-label">ZIP Code:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][27]" value="">
<input type="text" id="q_4_27" name="q[4][27]" size="10" value="16507" class="form-control " title="ZIP Code - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_41" class="col-form-label">Country:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][41]" value="">
<input type="text" id="q_4_41" name="q[4][41]" size="25" value="United States" class="form-control " title="Country - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_4_42" class="col-form-label">Is this a new address?</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[4][42]" value="">
<select id="q_4_42" name="q[4][42]" class="form-control " title="Is this a new address?">
<option value="">Select a value...</option>
<option value="37">No - this is my/our current address</option>
<option value="36">Yes - this my/our new address</option>
</select>
</div>
</div>
</div>
</div>
<div class="SurveyGroup SurveyGroup-5">
<div class="container SurveyGroupTable SurveyGroupTable-5">
<div class="row form-group">
<div class="SurveyHeader"><br>We want to make sure you're kept up-to-date with the Bulletin from the Bluff, our monthly e-newsletter.
<b>Please share your preferred email so we can deliver alumni news, event information, and more right to your inbox! </b><br></div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_5_30" class="col-form-label"><br>Preferred EMAIL:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[5][30]" value="">
<input type="text" id="q_5_30" name="q[5][30]" size="55" value="daniel.saner@ubs.com" class="form-control " title="Preferred EMAIL - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_5_31" class="col-form-label">Preferred PHONE:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[5][31]" value="">
<input type="text" id="q_5_31" name="q[5][31]" size="10" value="" class="form-control " title="Preferred PHONE - ">
</div>
</div>
</div>
</div>
<div class="SurveyGroup SurveyGroup-6">
<div class="container SurveyGroupTable SurveyGroupTable-6">
<div class="row form-group">
<div class="SurveyHeader"><b>Employer Information:</b></div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_32" class="col-form-label">Employer:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][32]" value="">
<input type="text" id="q_6_32" name="q[6][32]" size="50" value="" class="form-control " title="Employer - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_33" class="col-form-label">Position:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][33]" value="">
<input type="text" id="q_6_33" name="q[6][33]" size="25" value="" class="form-control " title="Position - ">
</div>
</div>
<div class="row form-group">
<div class="SurveyHeader">Employer Address</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_35" class="col-form-label">Address Line 1:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][35]" value="">
<input type="text" id="q_6_35" name="q[6][35]" size="50" value="" class="form-control " title="Address Line 2 - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_36" class="col-form-label">Address Line 2:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][36]" value="">
<input type="text" id="q_6_36" name="q[6][36]" size="50" value="" class="form-control " title="Address Line 2 - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_37" class="col-form-label">Address Line 3:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][37]" value="">
<input type="text" id="q_6_37" name="q[6][37]" size="50" value="" class="form-control " title="Address Line 3 - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_46" class="col-form-label">Address Line 4:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][46]" value="">
<input type="text" id="q_6_46" name="q[6][46]" size="50" value="" class="form-control " title="Address Line 4 -">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_38" class="col-form-label">City:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][38]" value="">
<input type="text" id="q_6_38" name="q[6][38]" size="25" value="" class="form-control " title="City - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_39" class="col-form-label">State:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][39]" value="">
<input type="text" id="q_6_39" name="q[6][39]" size="5" value="" class="form-control " title="State - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_40" class="col-form-label">ZIP Code:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][40]" value="">
<input type="text" id="q_6_40" name="q[6][40]" size="10" value="" class="form-control " title="ZIP Code - ">
</div>
</div>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_6_43" class="col-form-label">Country:</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[6][43]" value="">
<input type="text" id="q_6_43" name="q[6][43]" size="25" value="" class="form-control " title="Country - ">
</div>
</div>
</div>
</div>
<div class="SurveyGroup SurveyGroup-7">
<div class="container SurveyGroupTable SurveyGroupTable-7">
<script type="text/javascript">
function trimToLen(str, rmlen) {
x = str.length - 1;
while (rmlen > 0) {
c = str.charAt(x--);
if (c == '\r' || c == '\n') {
d = str.charAt(x);
if ((c == '\r' && d == '\n') || (c == '\n' && d == '\r')) {
x--;
}
rmlen -= 2;
} else {
rmlen -= 1;
}
}
return str.substr(0, x + 1);
}
function getTestStr(str) {
ts = '';
for (x = 0; x < str.length; x++) {
c = str.charAt(x);
if (c == '\r' || c == '\n') {
d = str.charAt(x + 1);
if ((c == '\r' && d == '\n') || (c == '\n' && d == '\r')) {
x++;
}
ts += "~\n";
} else ts += c;
}
return ts;
}
function remLenFun(txtfld, lenfld, maxlen) {
s = getTestStr(txtfld.value);
if (s.length > maxlen) {
txtfld.value = trimToLen(txtfld.value, s.length - maxlen);
s = getTestStr(txtfld.value);
}
lenfld.value = maxlen - s.length;
}
</script>
<div class="row form-group">
<div class="col-md-6 SurveyLabel">
<label for="q_7_44" class="col-form-label">Let us know what you've been up to since graduation!</label>
</div>
<div class="col-md-6 SurveyValue">
<input type="hidden" name="rq[7][44]" value="">
<textarea id="q_7_44" name="q[7][44]" cols="60" rows="5" wrap="soft" onkeyup="remLenFun(this,this.form.remLenq_7_44,1000);" onkeypress="remLenFun(this,this.form.remLenq_7_44,1000);" class="form-control "
title="Let us know what you've been up to since graduation!"></textarea>
<input type="text" name="remLenq_7_44" value="1000" size="7" readonly="" disabled="" title="This is the number of characters that you may type.">
</div>
</div>
</div>
</div>
<div class="SurveyGroup SurveyGroup-submit relative">
<input type="submit" name="btn_submit" value="Submit">
<div style="position: absolute; bottom: 0.25rem; right: 0.5rem; font-size: 0.5rem; color: #80C080;">81180</div>
</div>
</form>GET https://tr.snapchat.com/cm/i
<form method="GET" action="https://tr.snapchat.com/cm/i" target="snap08881894605973262" accept-charset="utf-8" style="display: none;"><iframe id="snap08881894605973262" name="snap08881894605973262"></iframe><input name="pid"></form>Text Content
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Welcome to Duquesne University!
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LET'S KEEP IN TOUCH!
UPDATE OR VERIFY YOUR INFORMATION TO STAY CONNECTED TO ALL THE EXCITING
HAPPENINGS ON THE BLUFF. PLEASE COMPLETE THIS FORM TO MAKE SURE YOUR ALUMNI
RECORD IS CORRECT.
--------------------------------------------------------------------------------
Survey
Here is the contact information we have on record for you and your household. We
use this information for mailings, invitations, and donation acknowledgments.
Title:
Enter your FIRST NAME:
Enter your PREFERRED FIRST NAME:
Enter your MAIDEN or LAST NAME at Graduation (if applicable):
Enter your LAST NAME:
Enter your PREFERRED FULL NAME:
Enter your primary CLASS YEAR:
Is your spouse/partner also an alumnus/a?
Select a value... No - Spouse or Partner is not an Alumnus or Alumna Yes -
Spouse Partner is Alumnus or Alumna
If your spouse/partner is NOT an alumnus/a, would you like them to be included
on our communication to you, including for acknowledgement purposes?
Select a value... No - I do not want my spouse/partner included in future
communications Yes - I want my spouse/partner included in future communications
Household
Spouse Title:
Enter your SPOUSE FIRST NAME:
Enter your SPOUSE PREFERRED FIRST NAME:
Enter your SPOUSE MAIDEN or LAST NAME at graduation (if applicable):
Enter your SPOUSE LAST NAME:
Enter your spouse PREFERRED FULL NAME:
Preferred Mailing Address
Address Line 1:
Address Line 2:
Address Line 3:
City:
State:
ZIP Code:
Country:
Is this a new address?
Select a value... No - this is my/our current address Yes - this my/our new
address
We want to make sure you're kept up-to-date with the Bulletin from the Bluff,
our monthly e-newsletter. Please share your preferred email so we can deliver
alumni news, event information, and more right to your inbox!
Preferred EMAIL:
Preferred PHONE:
Employer Information:
Employer:
Position:
Employer Address
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 4:
City:
State:
ZIP Code:
Country:
Let us know what you've been up to since graduation!
81180
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