Naturopathic Medicine Student Clinician White Coat Ceremony RSVP

FORM DUE BY: Tuesday, April 8, 2025
Name*
First Last
UWS Email Address*
This email will be used for all white coat ceremony updates and communication. Please continue to check it.
Enter Email Confirm Email
Do you plan to attend the white coat ceremony?*
The white coat ceremony will be on Friday, April 11, 2025 at 3 p.m. in Mt. Hood.
- Yes
- No
How many guests will you be inviting to attend the ceremony?
There are no physical tickets for guests.
I consent to have my name printed in the white coat ceremony program.*
I acknowledge that by clicking yes on this question my name and information on the white coat ceremony program may be displayed publicly online and in printed form. Although I am not required to release my records, I am giving my consent to release the following information: name, program, completion date and honors (if applicable).
- Yes
- No
Name as you would like it to appear on the ceremony program*
Phonetic (fon-et-ick) spelling of your name to assist pronunciation*
Please format spelling to look like: John-son An-der-son.
Photography
I acknowledge by clicking submit that there will be photography at this event and my picture may indefinitely be displayed publicly online and in printed form.
Phone
This field is for validation purposes and should be left unchanged.

FORM DUE BY: Tuesday, April 8, 2025