Michigan Public Health Alumni Reception | San Francisco Registration
Tuesday, September 10, 2019 | 6:00 - 7:30 pm

Palio | 640 Sacramento St, San Francisco, CA

Email address *
I plan to attend the event on Tuesday, September 10 in San Francisco, CA. *
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
Affiliation *
Department / Program *
Graduation Year(s)
If applicable - Provide degree(s) from SPH only. Example: M.P.H. '86 , Ph.D. '90
Your answer
Guest Name
If you are planning to invite a guest, please list their name below
Your answer
Please Do Not Post My Name in the List of Registrants
A copy of your responses will be emailed to the address you provided.
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