Michigan Public Health Alumni Reception | Washington D.C. Registration
Wednesday, November 6, 2019
Email address *
I plan to attend the event on Wednesday, November 6 in Washington D.C. *
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First Name *
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Last Name *
Please include your full last name. If your last name has changed, please write "current name (previous name)." Example: Smith (Olsen)
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First name and Last name as you would like them to appear on name tag *
Please feel free to include nicknames or abbreviations
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Affiliation *
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Department / Program *
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Graduation Year(s)
If applicable - Provide degree(s) from SPH only. Example: M.P.H. '86 , Ph.D. '90
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Guest Name
If you are planning to invite a guest, please list their name below
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