The University of Maryland School of Medicine and the University of Maryland Fund for Medicine are pleased to provide E-Mail for Life to our alumni! E-mail for Life means a lifetime of connections and information through the University of Maryland School of Medicine and the University of Maryland Fund for Medicine.

By reserving your personal E-Mail for Life account, you will be able to maintain a permanent e-mail address no matter how often you relocate or change e-mail providers.

You will also be able to proudly showcase your alumni connection to the University of Maryland School of Medicine and support of the University of Maryland Fund for Medicine.

Please complete the online form below. We will verify your alumni status and activate your personal E-Mail for Life account as soon as possible.

Account Information

Title:
Full Name:
Class Year:
Home Address:
City:
State:
Zip Code: (5 digits)	(00000 for international)
Home Phone Number:
Use home as primary contact address:	Yes No

Business Address:
City:
State:
Zip Code: (5 digits)	(00000 for international)
Business Phone Number:

Use business as your primary contact address:	Yes No

Alternate Address: (seasonal, etc.)
City:
State:
Zip Code: (5 digits)
Alternate Phone Number:
Use alternate as your primary contact address:	Yes No

Preferred E-Mail Address:
Practice Specialty:
Spouse's Name: (optional)
Fax Number: (optional)