Alumni Board Interest Form

Alumni Board of Directors interest form

Interested in becoming involved in the NEOMED Alumni Association Board of Directors or have a fellow alumnus/a in mind who would be a good representative?

Name*

Prefix

First

Last

Suffix
Class Year*
Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Home Phone*
Cell Phone
Email*
Employer*
Why are you interested in taking a more active role in the Alumni Association?*
Which area(s) of focus interest you the most?*
- Select All
- Student outreach
- Alumni recognition
- Alumni engagement and professional development
- Philanthropy
What is one idea you have to better engage NEOMED alumni with the Alumni Association and the University?*
Are you willing to attend three meetings each year (fall, winter, spring), including one meeting on the NEOMED campus?*
- Yes
- No
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Phone

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