University of Cincinnati College of Medicine

About / Administrative Offices / Alumni Affairs / Reunion Questionnaire

Will you attend the Alumni Reunion

Name

Class Year

Marital Status

Address

City

State

Zip Code

Your Specialty

Practice/Hospital

Office Address

Home Phone

Office Phone

Names and Ages of Children

Names and Ages of Grandchildren

Children in Medicine (Name & Alma Mater)

Current hospital, administrative, or teaching appointments & titles

News about yourself and your family that you would like to share with your classmates

Honors, Awards, Distinctions in past 5 years

Photos are welcomed and encouraged

This field is required

Office of Development & Alumni Affairs

College of Medicine
Medical Science Building
Suite G552
3230 Eden Avenue
Cincinnati, OH 45267