Michigan Public Health Chicago Reception Registration
Tuesday, May 1 | 5:30-7:00 pm | The Mid-America Club | 200 East Randolph Drive, Chicago, IL
I plan to attend the event on Tuesday, May 1 at The Mid-America Club *
First Name *
Your answer
Last Name *
Please include your full last name. If your last name has changed, please write "current name (previous name)." Example: Smith (Olsen)
Your answer
First name and Last name as you would like them to appear on name tag *
Please feel free to include nicknames or abbreviations
Your answer
Graduation Year(s)
Degrees from SPH only. Example: M.P.H. '86 , Ph.D. '90
Your answer
Email Address *
Your answer
Phone Number
Including Area Code
Your answer
Please Do Not Post My Name in the List of Registrants
See who is coming; view the registration list here: https://sph.umich.edu/alumni/Chicago-registrants.html
Once you have registered, your name and graduation year will be visible on the next business day. Thank you!
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