White Coat Ceremony

Guest List Form
On Saturday, October 1, 2016 the Geisel School of Medicine at Dartmouth will host a program to welcome the Class of 2020 to the profession of medicine. The ceremony will take place at 10:00 am in Rollins Chapel on the Dartmouth College Campus. Students and their guests (e.g. parents, and/or partners) are invited to participate in this significant ceremony in which first year students will receive their white coats.

It is always a memorable experience for both students and those who witness the first ceremony on their journey to becoming doctors. An invitation to this special event and to a reception, hosted by the Office of Student Affairs, will be mailed to each guest in early August with an RSVP date to respond.

To assist us with our planning, please identify each guest by filling out the information requested below.

Entries marked with * are required.

Student Name*:

Student contact number (cell)*:

Guest 1

First Guest Name:

Address 1:

Address 2:

Town:

State:

Zip/country code:

Country:

Telephone:

Special Needs:

parking, hearing enhancement, etc.

Dietary Restrictions:

Total Number of Guests From This Address:

Guest 2 (Not at first address)

Second Guest Name:

Address 1:

Address 2:

Town:

State:

Zip/country code:

Country:

Telephone:

Special Needs:

parking, hearing enhancement, etc.

Dietary Restrictions:

Total Number of Guests From This Address:

Guest 3 (not at either address above)

Third Guest Name:

Address 1:

Address 2:

Town:

State:

Zip/country code:

Country:

Telephone:

Special Needs:

parking, hearing enhancement, etc.

Dietary Restrictions:

Total Number of Guests From This Address:

Please submit this form no later than August 5th, 2016. If you have additional questions please call us at (603) 650-1509 or email Tina.L.Wilcox@Dartmouth.edu.

If you have additional questions please call us at (603) 650-1509 or email Tina.L.Wilcox@Dartmouth.edu.