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

*

Send me a copy of my responses

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