UNC SOM Class of 1987 - UNC Medicine

35th Reunion Questionnaire

As we prepare for your upcoming reunion in the Spring of April 2021,

we would love to get updates on your professional and personal lives since we last met.

These will be used to create a Class Reunion Booklet that will be distributed at the reunion.

You are encouraged to send in one personal photo for the Booklet via email to samantha_south@med.unc.edu.

We’d welcome your responses to the class questionnaire by December 15th. Thank you!

Questions? samantha_south@med.unc.edu or 910-548-4990

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

What has been your main professional focus during the last 35 years including practice specialty, setting, and type of work?(Required)

Please share a brief update on your life outside of work (i.e. family updates, community involvement, travel, recreational/athletic/musical pursuits)(Required)

Information Disclaimer:(Required)

Yes, you may share the information I have provided in the booklet to be distributed

No, I do not give my permission to share this information in the booklet but you may use this information to update internal records.