ULSOM White Coat Ceremony/Orientation Questionnaire
First Name
Your answer
Last Name
Your answer
Gender
T-Shirt Size
These will be unisex 50% Cotton / 50% Polyester. Available sizes are Small - 4XL.
Required
Dietary Restrictions
Many lunches and dinners are provided during orientation week. If you have any special dietary needs, please list those below.
Your answer
White Coat Size
META 738 and 739 are the styles we order. Available Men's Sizes - 32-56 Regular or 38-56 Long (even number sizes only); Available Women's Sizes - 0-20 Regular, 8-20 Tall, or 40-48 Regular (even sizes only). Unfortunately, the company we order from does not have petite sizes.
Your answer
Length
Name to go on your medical student name badge (that you will wear on your white coat).
(Ex: George M. Franklin, George Franklin, Jr., or George Matthew Franklin)
Your answer
Name you would like us to say as you walk on stage at the White Coat Ceremony (this will also appear in the White Coat Ceremony program)
(Ex: George M. Franklin, George Franklin, Jr., or George Matthew Franklin)
Your answer
Is your name commonly mispronounced?
Phonetic Pronunciation
If you answered YES to the previous question, please assist us in properly pronouncing your name during the ceremony by writing it phonetically. Provide pronunciation for both first and last names.
Your answer
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