CHM Alumni & Students Connectivity Program
College of Human Medicine


       CHM Connects

Instructions
The College of Human Medicine medical students would like to seek guidance from the College of Human Medicine alumni as they embark on the journey through medical school. As Alumni, you are a natural connection to share your knowledge and experiences with current medical students. CHM Connects was created by your alumni board as a tool for students and alumni to connect.
 
Please become a part the CHM Connects network by completing the enrollment form. The information you provide will only be used for college purposes and will not be shared with outside organizations. As a participant of this program, your information will be part of a secure online directory for only Michigan State University College of Human Medicine alumni and students to utilize.
 
CHM Alumni & Students Connectivity Program
First Name:
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Last Name:
required
Primary Email Address:
required
Home Address 1:
Home Address 2:
Home City:
required
Home State:
required
Home Zip:
required
Phone Area Code:
Home Phone Number:
Generalized Specialty
required
Sub Specialty
Residency 1:
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Residency 1 University or Location:
required
Residency 2:
Residency 2 University or Location:
Fellowship
Fellowship University or Location
MSU College of Human Medicine Graduation Year
required
Practice Location - City
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Practice Location - State
required
Type of Practice (Check all that apply)





If you selected Academic or University for type of practice, please enter the name of the institution
Preferred Contact Method
required
Please select the community campus you attended:
required
Areas of student connection interest (Check all that apply)








required
I would like join the CHM Connects program:
required