Please print registration form and mail or fax it to the Office of Alumni Affairs:
Schwartz Lecture Hall Ground 4-40-0
550 First Avenue
New York NY 10016
Telephone: 212-263-5390
Fax: 212-263-6690
Full Name: ___________________________________________________
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Home Address: ________________________________________________
________________________________________________
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Home Phone: _________________________
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Work Address: _________________________________________________
_________________________________________________
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Work Phone: __________________________
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Email: _______________________________
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Graduation Year: __________________
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Date of Birth: ___________________
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Social Security Number: ____________________
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I am an alumnus/alumna
of the NYU School of Medicine and have read and agree to the
terms of use for the NYU School of Medicine Alumni Digital
Library Web site.
Signature_____________________________________Date___________________________
You will receive an email with your username
and password. The registration process takes approximately
one week.
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