Student Who Will Not Be Participating in
Medical School Commencement 2014

* Required

Name *
Email *
Phone
Please choose one of the following *
I will be picking up my diploma from the Office of Medical Student Education following Commencement.
Please mail my diploma to the following (shipped via UPS) following Commencement.
  Name
Street
Apartment #
City
State
Zip Code
Please note: When shipped via UPS, a signature may be required in order for your diploma to be left at the above address. We will email you when we ship the diploma so you are aware of when it might arrive.
Reason for not participating in Commencement *