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 AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code -
Preferred Email
Preferred Phone	Home Cell Business
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.*	Select size... Small Medium Large X-Large XX-Large