Alumni & Friends

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NAME

First*

Last*

MAILING ADDRESS

Street Address*

Address Line 2*

City*

State*

ZIP/Postal Code*

PREFERRED EMAIL ADDRESS

Email*

PREFERRED PHONE NUMBER

Phone*

CoPPS, IPH GRADUATING CLASS YEAR(S)

Year

CoPPS, IPH DEGREE(S) EARNED

Degree

CURRENT EMPLOYER

Employer

CURRENT JOB TITLE

Job Title

ARE YOU (Check all that apply)

Check Box

In Training

In Practice

Retired

PLEASE LIST SPECIALTY OR PRACTICE AREA

Specialty or Practice Area

I PREFER TO RECEIVE COMMUNICATIONS FROM THE COLLEGE IN THE FOLLOWING WAYS (CHECK ALL THAT APPLY)

Communication Preference

Social media (such as, LinkedIn, Instagram, Facebook or Twitter

Mailed Information

Website

Digital Newsletter

I WOULD BE INTERESTED IN LEARNING MORE ABOUT (CHECK ALL THAT APPLY)

Learn More

Mentoring students one-on-one

Speaking to groups of students

Helping with professional development activities, such as mock interviews and resume review

Attending alumni networking events or reunion events

Continuing education opportunities

Other (please specify below)

If other, please specify

College of Pharmacy and Pharmaceutical Sciences, Institue of Public Health
1415 S. Martin Luther King, Jr. Blvd.
Tallahassee, Florida 32307

P:: (850) 599 3301
F:: (850) 599 3347

	GIVING TO COPPS	ALUMNI ASSOCIATION
	MEMBERSHIP APPLICATION	MEMBERSHIP APPEAL LETTER

Alumni & Friends

ALUMNI CORNER

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