School Alumni Chapters

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  • Registration Form

    I plan to attend*:
    Class Year*
    Street Address*
    City, State, Zip Code* -
    Phone (Home)()-- ext.
    Phone (Business)()-- ext.

    Friday, August 23, 2013

    11:00 a.m. - Welcome Lunch and Tour
    Enjoy lunch with your classmates and the Dean of the School of Medicine followed by "Back to the Future in Medical Education" and tours of campus.
    Norman C. Nelson Student Union
    $25 per person # = $
    2:15 p.m. - Tour
    UMMC Campus Tours including teh Guyton Research Complex, Simulation Suite, and "Memory Lane". (2hr ride/walk tour)
    Individuals may request earlier return to their parking area if desired.

    Please note if you would like to add an optional area to the end of your tour:

    Other (please describe):
    6:00-9:00 p.m. - An Evening of Mississippi Traditions
    Enjoy Southern Cuisine and Mississippi History while visiting with your classmates and the Dean of the School of Medicine as we pay special tribute to our Golden Grads - Class of 1963 (An event for ALL classes)
    Old Capitol Museum
    # attending* X ($50 per person) =

    Saturday, August 24, 2013

    7:00 p.m. - Cocktail Reception/Class Dinners
    Country Club of Jackson
    Specify any special dietary needs:
    $100 per person # = $
    7:30 p.m. - Class Photo $NC
    (Please be prompt so you will be included in your class photograph!)

    Medical Reunion Scholarship Fund

    Student scholarships are not possible without alumni support.
    We will announce each class gift at the reunion lunch so your participation is needed to make your class 100%!

    Medical Reunion Class Of:
    Scholarship Gift
    (See Booklet page 8)
    Amount will be added to credit card total above.

    Pay online by Credit Card

    Total Amount Enclosed
    Method of Payment:
    Name as it appears on card:
    Card Billing Address:
    Card Number:
    Expiration Date: