2024 UVA Department of Emergency Medicine Alumni + Friends Reception at VACEP

Alumni and friends are invited to join us for a reception at VACEP on February 23. Registration is required.

First Name*
Last Name*
Preferred Nametag Name*
Preferred Email Address*
What is your UVA Affiliation?*
Preferred Telephone Number (this will be used if there is a last minute change of plans)
Additional Information
Do you have any mobility restrictions?*
- Yes
- No
If yes, please briefly explain
Do you have any dietary restrictions or allergies?*
- Yes
- No
If yes, please briefly explain

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