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SOM Fall Alumni Board Meeting and Dinner

SOM Fall Alumni Board Meeting 2019

Please join us for the School of Medicine Fall Alumni Chapter Board Meeting and Dinner 

Tuesday, November 19, 2019
4-5:30pm 
School of Medicine Conference Room 323 
Dinner at 6pm at The Manship 

Please register by November 12

Medical Alumni Board Meeting

I plan to attend:*
 
First Name*    
Last Name* 
Address
City, State, Zip Code     -
Phone*() - ext.
Email* 

Dinner Registration

I plan to attend the dinner ($50 per person):*
 
Total Number Attending Dinner:     Cost:
Dinner Guest Name
Please list any accessibility resources
(e.g. sign language interpreters, wheelchair
access, dietary, etc.) you may
require during this event.

Credit Card Processing

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Credit Card Expiration Date*
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(Located on the back of the card)