School Alumni Chapters


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  • 2013 MSMA/Young Physicians Cruise

     2013 MSMA/YP Cruise 2013 MSMA/YP Cruise1

     

  • Name*
    Spouse
    Address*
    City, State, Zip Code* -
    Email
    Home Phone()--
    Bus. Phone()-- ext.
    Cell Phone()--
    Enjoy a cocktail reception and dinner with UMMC Alumni and Dr. James Keeton, Vice Chancellor for Health Affairs and Dean of the School of Medicine followed by recognition of the 2013 Medical Alumni Chapter awards.
    I will attend the Medical Alumni Chapter dinner ($55 per person)
    Please note your preference for menu selection: # Beef # Fish # Vegetarian
    Total Attending: @$55 per person = $
    Spouse/Guest Name
    Billing Information
    Total Amount Billed:
    Card Type:
    Card #
    Exp. Date
    Name as it appears on card