2023 Pre-Health Symposium Attendee Registration

First Name

Last Name

Email Address

What is your job title/occupation?

What is your place of employment?

If you are hosting a table at the Pre-Health Symposium, there is a fee for your participation, which contributes to the cost of hosting the event. We will invoice you for your participation.
Questions? Contact Talia at unohealthcareers@unomaha.edu.

Please enter your cost center number (if in NU system) and/or billing address (street, city, state, zip) where we can invoice you.

Please enter the email or phone number for your accounts payable department.

Please enter the legal name of your business, school, or other entity for billing purposes.

Please provide a brief description of your program for our promotional materials.

Please upload an image file of your program's logo for our website and promotional materials.

First Name

Last Name

Email Address

Gender

MaleFemaleTransgender, non-binary, or another gender

Date of Birth

Ethnicity

Hispanic/LatinoNon-Hispanic/Non-Latino

Home Street Address

Home City

Home State

Home Zip Code

Name of High School

What year will you graduate?

College

Anticipated Graduation Year

NUID Number

UNO Students Only

Name of College if not listed

Major or Degree Program

If you are in a pre-health track, please include this. Ex: Pre-Med, Pre-Nursing, etc.