Please complete the following fields so that the HPMAA can stay in touch with you. Please note that the information you submit in this survey will be shared with the HPMAA board members.

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* 1. First Name

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* 2. Last Name

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* 3. Previous Name, if different when you were a student

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* 4. Personal Email

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* 5. Work Email

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* 6. Personal Phone Number

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* 7. Work Phone Number

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* 8. Please provide your LinkedIn URL so we may invite you to connect (e.g. www.linkedin.com/in/username).

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* 9. How would you like to hear from HPMAA? Please select all that apply.

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* 10. What is your 5-digit zip code? (If outside the U.S., please enter your country of residence.)

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* 11. Graduation Year

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* 12. What degree did you earn?

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* 13. Current Employer

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* 14. Current Job Title

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* 15. Are you interested in engaging with any HPMAA committee? Please select all that interest you. Click here to visit HPMAA's website to learn more about each committee.

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* 16. Please rate your level of interest in the following events and professional development opportunities through the HPMAA. Please select all that apply.

  Not Interested Somewhat Interested Moderately Interested Very Interested
Leadership roundtable with other professionals
Lectures and panel discussions
Business network events
Family-friendly programming
Personal support workshops (e.g., managing work/life balance)
Class reunion
Social events (e.g., wine tasting, trivia night, exercise class, guided meditation)
Resume writing and interviewing
Community volunteering

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* 17. Are you interested in any of the following volunteer opportunities? Please select all that apply

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* 18. Do you have any other suggestions for networking and professional development opportunities that you would be interested in?

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