Advocate Profile

Name:
            (Include First, Middle, Last)

Mr. Mrs. Miss Ms. Dr. (Please check one)

Residential Mailing Address: (Include Street, City, State, Zip)

County:

Home Phone: Work Phone:

Professional Title:

Employer/Company: (Optional)

Preferred Mailing Address: Home Work Campus Address
(Please check one)

(Include Street, City, State, Zip)

Please mark the appropriate response:

I wish to serve as an Advocate for the University of Pittsburgh.

Thanks, but I no longer wish to serve as an Advocate for the University of Pittsburgh.

University of Pittsburgh Relationship: (Check all that apply)

Alumni Parent Student Friend Faculty Staff

If Alumni:

School:

Class/Graduation Year (e.g.: 1970)

Degree:

Area(s) of Interest:

If Faculty, Staff or Student:
Department and/or School:

Title or Major & Year:

PA General Assembly Relationship: (For Relationship, please use all that apply)
C=Constitutent; PA=Personal Acquaintance; BUS=Professional or Business;
SEC=Support Election Campaign

Representative House District No. Relationship
Representative House District No. Relationship
Senator Senate District No. Relationship
Senator Senate District No. Relationship

I am willing to:
Visit my legislator(s) at their local offices on issues important to Pitt
Send emails, write letters, and/or make phone calls to elected officials
Attend legislative briefings, advocacy training sessions, and other events
Write letters to the editor
Recruit others

We encourage you to share this opportunity with other supporters of the University and ask them to participate as well.

Contact:
Nicole Urti
710 Alumni Hall
4227 Fifth Avenue
Pittsburgh, PA 15260
Email: urti@pitt.edu
Phone: 412-624-7719
Fax: 412-624-7707