50th Questionnaire

UNM Dept. of Psychiatry 50th Reunion Survey

Thank you for completing this short questionnaire. Your responses will help us create a 50th reunion that is fun and valuable to you.

* 1. The Department of Psychiatry's 50th reunion event is scheduled for April 24-26, 2015, in Albuquerque. Would you be likely to attend this reunion? (Knowing the number of attendees will help us plan.)

Yes

Maybe

How many?

* 2. Please rate the following potential activities for the 50th reunion.

	Would attend	Might attend	Would not attend
Friday afternoon Grand Rounds (1-2 CMEs)	Friday afternoon Grand Rounds (1-2 CMEs) Would attend	Friday afternoon Grand Rounds (1-2 CMEs) Might attend	Friday afternoon Grand Rounds (1-2 CMEs) Would not attend
Friday evening lecture (Lecture would also be open to the public.)	Friday evening lecture (Lecture would also be open to the public.) Would attend	Friday evening lecture (Lecture would also be open to the public.) Might attend	Friday evening lecture (Lecture would also be open to the public.) Would not attend
Friday evening cocktail reception	Friday evening cocktail reception Would attend	Friday evening cocktail reception Might attend	Friday evening cocktail reception Would not attend
Didactic CME session	Didactic CME session Would attend	Didactic CME session Might attend	Didactic CME session Would not attend
Interactive CME session	Interactive CME session Would attend	Interactive CME session Might attend	Interactive CME session Would not attend
Writer's Tea	Writer's Tea Would attend	Writer's Tea Might attend	Writer's Tea Would not attend
Giving or attending a special workshop or session	Giving or attending a special workshop or session Would attend	Giving or attending a special workshop or session Might attend	Giving or attending a special workshop or session Would not attend
Class-specific event	Class-specific event Would attend	Class-specific event Might attend	Class-specific event Would not attend
Family event (ie. barbeque or picnic-type activity)	Family event (ie. barbeque or picnic-type activity) Would attend	Family event (ie. barbeque or picnic-type activity) Might attend	Family event (ie. barbeque or picnic-type activity) Would not attend
Tour of Dept of Psychiatry facilities	Tour of Dept of Psychiatry facilities Would attend	Tour of Dept of Psychiatry facilities Might attend	Tour of Dept of Psychiatry facilities Would not attend
Tour of local attraction (ie. Breaking Bad Tour, Pueblo or Petroglyphs)	Tour of local attraction (ie. Breaking Bad Tour, Pueblo or Petroglyphs) Would attend	Tour of local attraction (ie. Breaking Bad Tour, Pueblo or Petroglyphs) Might attend	Tour of local attraction (ie. Breaking Bad Tour, Pueblo or Petroglyphs) Would not attend
Community Service Project	Community Service Project Would attend	Community Service Project Might attend	Community Service Project Would not attend

Other (please specify)

* 3. If you are bringing children, which events would they attend with you?

Friday Grand Rounds

Friday lecture

Friday cocktail reception

Saturday CME session

Saturday evening dinner event

Sunday family event

Saturday writer's tea

Class specific events

Tours of the facilities

Local attraction tour(s)

Suggestions for children

* 4. Which of the following should be included in the Saturday night event?

	Include	Do not include
Alumni awards	Alumni awards Include	Alumni awards Do not include
Honoring past leaders	Honoring past leaders Include	Honoring past leaders Do not include
Honoring past staff	Honoring past staff Include	Honoring past staff Do not include
Music and Dancing	Music and Dancing Include	Music and Dancing Do not include
Music only	Music only Include	Music only Do not include
Skits	Skits Include	Skits Do not include
Buffet	Buffet Include	Buffet Do not include
Sit down dinner	Sit down dinner Include	Sit down dinner Do not include
Mix and mingle cocktail hour	Mix and mingle cocktail hour Include	Mix and mingle cocktail hour Do not include
Chairman presentation	Chairman presentation Include	Chairman presentation Do not include

Other (please make suggestions)

* 5. For the Saturday night event, please tell us whether you prefer suits or jean (formal or informal) and

* 6. How much would you be willing to spend per person for the weekend's activities?

Nothing

Up to $100

$100 - $250

* 7. Have we left anything out? Are there other events you would like to suggest?

* 8. Please enter your current contact information so that we can keep you informed. Outside of UNM, we will not share this information without your consent.

Name:

Email:

Address:

Address 2:

City/Town:

State:

ZIP:

Resident, Fellow, Intern, or Employee (list all)

Year of Graduation or years at the Dept.

Phone Number:

* 9. What is the best method to stay in touch with you?

Phone number above

Mailing address above

* 10. I would be willing to:

	Yes	No
Assist with locating other alumni and former faculty or staff	Assist with locating other alumni and former faculty or staff Yes	Assist with locating other alumni and former faculty or staff No
Assist with contacting other alumni, former faculty or staff	Assist with contacting other alumni, former faculty or staff Yes	Assist with contacting other alumni, former faculty or staff No
Assist with planning the 50th reunion	Assist with planning the 50th reunion Yes	Assist with planning the 50th reunion No
Volunteer at the reunion to help with events	Volunteer at the reunion to help with events Yes	Volunteer at the reunion to help with events No

Please tell us the best time to contact you regarding this: