Student Registration for Black Medical Alumni Weekend

First Name*

Last Name*

Preferred Nametag Name (e.g., John Smith, Jr., Beth Jones)*

Email*

Cell Phone*

Affiliation*

MD Year*

Department

Please select the events you will be attending on Friday, April 8:

Please select the events you will be attending on Saturday, April 9:

8-9am: Networking Breakfast (CMMEB Learning Studio)
9-9:45am: Update from the SOM with Dr. Tracy Downs (CMMEB Auditorium)
10-11am: Alumni and Student Panel: Voices from History and Our Future (CMMEB Auditorium)
11:15am-12pm: Recognition Ceremony (CMMEB Auditorium)

Do you have dietary restrictions?*

Please describe dietary restrictions here.

Do you have any mobility restrictions?*

Please describe mobility restrictions here.

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