St. Basil Society Email List
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indicates required
Name:
Email:
Comment:
Email Address
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First Name
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Last Name
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Phone Number
By adding your phone number, you will be added to our GroupMe. This is not required!
Role/Year
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Please list your role, year (if student/resident), school (if applicable). For example: TAMU MS2, Surgery PGY3, UTSW PA student 1st year, Faculty Internal Medicine, etc.
