Cal Poly Pomona

Alumni Host Registration Form

Alumni hosts have until January 3, 2014 to submit the registration form to host a dinner. Alumni hosts and co-hosts will be contacted by January 17, 2014, with a confirmation that will include the names of students participating in the dinner. The Office of Alumni Affairs will handle the invitations and a student liaison will be instructed to RSVP to their alumni host at least three days prior to the scheduled dinner. Alumni hosts are valued and appreciated for taking time out of their day to host a student dinner. 

Please fill out the following form.

I would like to:

If hosting a dinner at a restaurant, provide restaurant name:

Name of alumni you are co-hosting dinner with:

I am available to host or co-host a dinner on:



First Name
Last Name
State      Zip
Day Phone
Evening Phone
Grad Year
Clubs/Activities you were involved in as a student

Business /Profession

Hosts Only

Check all that apply:

I can host vegetarian guests
6 guests are fine
I would like to have a co-host

My home is wheel chair accessible
Make this dinner for  guests
I have already selected a co-host

My co-hosts is:

Co-Host Address
State      Zip
Co-Host E-mail
Day Phone
Evening Phone



Thank you for your support!

Question, please contact or (909) 869-5406