Alumni Form

The Dimensions program is charged with providing high quality academic and experiential learning opportunities for Cornell students interested in healthcare. Cornell alumni play an important part in meeting this charge. The information we are requesting below is vital in both tracking the success of our graduates after they leave Cornell, and assisting our current students. If you are interested in assisting the Dimensions Program in any way, please indicate your interests below in the appropriate fields.

This information will only be used for the Dimensions program. To update your complete alumni information, please visit the web site of the Alumni Engagement Office.

Educational Information

Full Name: Cornell Graduation Year:

Major(s):    Minor(s):

Graduate or Professional School(s):

Graduate Degree(s) (MD, DDS, PhD, MPH):

Graduate Specialization (Immunology, Health Policy, etc):

Graduate/Professional School Graduation Year:  

Did you enter graduate school immediately after graduating from Cornell?

yes no   If no, how many years later was it?

When you were applying to graduate school, how many...

Times did you take the admissions test (MCAT, DAT, GRE)?
Schools did you apply to?
Schools offered you acceptance?

Professional & Contact Information

Title: Area of Specialization:

Organization and Department:

City:     State:

Phone: E-mail:

Dimensions Program Interests

Conduct a lecture on an interesting health topic in my field.
Participate in an on-campus workshop.
Allow students to contact me with questions about my career and training.
Provide a job shadowing opportunity for a student.
Provide an internship opportunity for a student.
Participate in an alumni career panel.
Mentor a student.


In what ways did Cornell help you feel prepared for graduate/professional school and/or your current job?

How could Cornell better prepare students for graduate/professional school and the "real" world?

What one piece of advice would you offer Cornell students interested in pursuing health careers?

We would like to list alumni and their accomplishments on the Dimensions web site. May we post your information? The format will be:

Dr. John Smith
Mount Vernon, IA
University of Iowa

yes no

Thank you for providing this information to the Dimensions program. Please contact the Dimensions coordinator if you have any questions or further comments.