University of Connecticut Health Center
Ph.D. Graduates of Biomedical Science Program Survey

Please make corrections to information provided. Questions may be directed to:
Catherine Gibbons Way, cway@foundation.uconn.edu, phone: (860) 679-6034.

Personal Data
Name:  
Address 1:
Address 2:
City
State
Zip Code
Country:
Phone:
Fax:
Cell Phone:
Email:
   
Ph.D. Program Data  
Year of Graduation:
Major Advisor:
Field of Study: Biomedical Science
Specialization:
   
Current Professional Data  
Current Professional Title:
Current Employer:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:
Start Date:
Department:
Division:
Phone:
Fax:
Email:
Institutional Affiliation:

Please list any professional, community, service or philanthropic honors or awards you have received with date bestowed.