Class of 2013 Contact Information

Please complete and submit only if your information has changed since November 12, 2012.
*Information will be utilized for the Memory Book, commencement and hometown releases.
   
Students First Name
  Last Name
  Mailing Address
  Phone Number
  E-Mail
   
Spouse/Partner First Name
  Last Name
  Address
  Phone Number
  E-Mail
     
Parent #1 First Name
  Last Name
  Relationship
  Address
  E-Mail
     
Parent #2 First Name
  Last Name
  Relationship
  Address
  E-Mail
     
Hometown  
     
    If you have questions regarding your submission,
contact Betty Woodley or Michelle Pendergast.


 
 
 
 
  Office of Student Affairs
Ohio University Heritage College of Osteopathic Medicine
Grosvenor Hall, Athens, Ohio 45701
Tel: 740-593-2333 FAX: 740-593-2320
Copyright Ohio University (Home)
Last updated: 11/09/2012