ROBERT WOOD JOHNSON
MEDICAL SCHOOL
ALUMNI ASSOCIATION

ALUMNI REUNION WEEKEND RSVP CARD
October 10 - 11, 2009
RSVP by September 30, 2009

Please enter your Name and Affiliation

First Name

Last Name

Email (To send a confirmation)

Phone (In case we need to contact you)

Class of Piscataway/ Camden (Clear) Current Resident/Fellow

Faculty/Admin/Other -- Department/Affiliation:

Spouse/Guest Name (Ignore the Class/Location lines if not a RWJMS Alum)

First Name

Last Name

Class of Piscataway/ Camden (Clear) Current Resident/Fellow

Faculty/Admin -- Department/Affiliation:

Number Attending: @ $125 per person ($50 per person residents/fellows)

Gala Dinner Dance -- Dinner Selections (Please select dinner(s) from the choices below)

Filet Mignon Salmon Vegetarian Kosher

Sunday Alumni Breakfast (Please indicate the number of each attending (Adult/Child) )

Adult (@$20 per person) Child (age 5-10 @$10 per person)

Enter Any Comments or Special Requests:

Total Cost: $

Click Pay Online to pay with PayPal (credit card/bank account) or click
Print Form & mail with your check (to RWJMS Alumni Association) to:

Roberta Ribner
RWJ Medical School Alumni Association
335 George Street, Suite 2300
New Brunswick, NJ 08903

Questions? Contact Roberta Ribner at 732-235-6310 or ribnerrs@umdnj.edu.