School of Medicine

Medical Reunion Bio Information

Online registration has closed, but please call the Office of Alumni Affairs if you have any questions at 601-984-1115 or email us at alumni@umc.edu.

Information submitted will be published and disseminated to your classmates. Those not submitting details will only have their yearbook photo and name printed in the bio book.

* = Required Fields

Submission Deadline: Friday, July 30, 2021

Graduation Year*

Name*

Spouse

Address (Home)*

City/State/Zip Code*

City
State
Zip Code	-

Preferred Email

Preferred Phone

Phone Number

() - ext.

Practice Specialty

Retired?Yes
No

If yes, year retired

Residency School(s)

Professional/personal accomplishments since medical school

Best memory of your time in the School of Medicine

Classmate whom you have remained in close contact since graduation.

Favorite faculty and why

Names, ages, and careers of your children.

Hobbies, special interests, activities, or travel

Anything else you'd like to share with your classmates.

Please submit a recent photo of yourself

*.gif,*.jpg,*.jpeg,*.bmp,*.png,*.tif,*.tiff

Please select your pullover size.*