Student Contact Form

University of Nevada, Reno
Department of Speech Pathology and Audiology
Student Contact Form

The purpose of this questionnaire is to maintain contact with UNR master's degree students post graduation. The information will be used for the following purposes:

  1. To create an alumni database so that alumni wishing to contact other alumni may do so through this department.
  2. To monitor employer satisfaction through an Employer Rating Form that will be distributed during or after completion of your Clinical Fellowship Year
  3. To poll graduates on their opinion of the quality of the graduate program. Again, this form will be mailed or e-mailed to you upon completion of your Clinical Fellowship Year.

Name (Required):
Address:
e-mail address:
Phone no.:
Permanent relative address (This is an address at which you may be contacted even though you may have moved or are in transit):
(contact person):
Permanent phone #:
If you have already secured a CFY position, please designate the place of employment and phone number and the name of your CFY supervisor.
Place of employment:
Address:
Phone number:
Name of CFY Supervisor:

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Please contact klewis@med.unr.edu