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Contact Us:
Development & Khatali Alumni Relations
UNM School of Medicine
Basic Medical Sciences Bldg. #182B
MSC 08 4720
1 University of New Mexico
Albuquerque, New Mexico 87131
Telephone: 505.272.5112
Fax: 505.272.6581

Office of Development & Khatali Alumni Relations

Khatali - The SOM Alumni Association

Keep in Touch

Let us know what you’re up to these days!
Responses will be shared on our website and in UNMed magazine.

First Name
Last Name
Middle Initial
Class year
Work Phone
Fax
Work Address
Home Phone
Home Address
E-mail
Where do you prefer to be contacted?
Where are you practicing now?
Type of practice
Area of speciality, subspeciality
Where did you complete your residency?
Year completed
Spouse's name
Is your spouse a UNM graduate? If so, what department/college?	yes no
Children names and ages
Grandchildren names and ages
List any honors or awards you’ve received recently
List any special projects or research you’re involved in
May we share this information with other alumni on our web site?	yes no
May we list your e-mail on our web site?	yes no
Would you like to receive information about:
School of Medicine research programs	yes no
School of Medicine clinical care programs	yes no
School of Medicine educational programs	yes no
Endowments	yes no
Planned Giving to the School of Medicine	yes no
Other giving opportunities	yes no
Would you like to be contacted by the school development officer?	yes no
Additional comments or questions