Alumni Board Interest Form

Name*

Last Name*

Email Address*

Degree*

PharmD

PhD

Masters

Class Year*

Home Address*

City*

State*

Zip Code*

Interested in joining the University of Utah College of Pharmacy Alumni Association?*

Please share why are you interested in joining the University of Utah College of Pharmacy Alumni Association

Would you be able to attend a monthly board meeting? (Board meetings alternate between virtual/in person)*

Yes

No

Which areas are you particularly interested in?*

Please check all that apply

Select

Send me a copy of my responses

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