Career Alumni Advisory Network (CAN) Registration

1. Personal Information:

name:

phone: - -

e-mail:

status when you were at UCSF: Please choose one Dental Student Life Science/Behavioral Science Student Medical Student Nursing Student Pharmacy Student Physical Therapy Student Postdoc Resident Other

year you left UCSF:

2. Most Recent Professional Information:

company/employer:

type of work: (i.e. clinical practice, research, consulting etc.)

address:

city:

state: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY

zip:

phone: - -

position/ job title:

e-mail:

3. Comments/Additional Information:

Please share any information that you think will help up know your area of expertise for career panels, informational interviews, etc. For example, if relevant: what is your clinical specialty; did you complete a joint degree; what field of research did you conduct at UCSF; what lab were you in, etc.