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USC School of Medicine Alumni Information

Information will be for office use only -- NOT for publication.

Thank You!

First Name
Middle Name/Initial
Last Name
Preferred Name or Nickname
Specialty
Board Certified Yes No
Graduation Year
Office Address
City
State
Zip
Practice County
Do you serve in a medically underserved community?

Home Address
City
State
Zip

Send Alumni Mail to: Home     Work
Please List in the Alumni Directory: Home     Work address.
Spouse's Name

INFO BELOW NOT FOR PUBLICATION


Work Phone
Work E-mail
Work Fax    
Home Phone Home E-mail
Cell phone number Prefered Email:
Children's Names,
Dates of birth


Parent's name and address (for SOM SC Medicine Magazine mailing list and invitations to SOM Events):

Please submit “Class Notes” (and pictures to Debbie.Truluck@uscmed.sc.edu ) for the next edition of our SC Medicine magazine.  We would also appreciate you sending information on your career (or a fellow alum’s) to be considered for a feature story in a future SOM magazine (may include extra-curricular activities, community involvement, etc.)  We welcome your suggestions/ideas for the SOM Alumni Association.

I would like to:

Become involved with the SOM Alumni Association

Serve on the Board

Other area of interest:

 I would like to be contacted about the SOM Columbia area Preceptorship Program and/or hosting medical students outside the Columbia area (or you can fill out the mentoring opportunities form at http://alumni.med.sc.edu/) or contact Student Services at 803-216-3632.

To update your info by phone/email:
Debbie Truluck at 803-216-3303/ Debbie.Truluck@uscmed.sc.edu
THANK YOU!


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