Alumni / Visitor Reply form

 

Alumni:

We would appreciate it if you would fill out the following biographical information and return it to NSN. The intent of this form is to provide current information so that alumni can be kept up-to-date with the activities of the house. Additionally, we would like to create a directory which would be available to all alumni. Please return the form via postal mail to Alumni Committee, 1912 Geddes Avenue, Ann Arbor, MI 48104, or alternatively you can send it via the electronic form below. You can also send your responses via email to nusigmanu@umich.edu.
THANKS!!

Visitors:

If you would like more information and want someone to contact you please fill out the name, email address and the questions or comments portion of this page and someone will get back with you. or alternatively you can send it via the electronic form below. You can also send your responses via email to nusigmanu@umich.edu.
THANKS!!

 

Please complete the following survey. When you are done, click on the "Submit Form" button.

Last name: First name:

Class:

Preferred mailing address:
Is this the same address where you received this? yes no

Street:
City: State: Zip code:

E-mail address (if applicable):

Phone number:

Medical Specialty:

Hospital Affiliations:

 

Life History and Distinctions (since medical school):

Brief Family Status:

Questions or Comments:

Do you think reviving alumni relations is a good idea?
yes no maybe

Would you be willing to speak with current NSN members about career choices and residency programs?
By phone? yes no
By email? yes no

Please send email to nusigmanu@umich.edu to share your comments on this and/or any other subjects.

 

Created By: Mark Personsett