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Memory Book Form
MCW/Marquette Medical Alumni Association
2025 Memory Book Form
Please complete this Memory Book form. It will be a wonderful keepsake for your class. We will see to it that you receive a digital copy of your class’s memory book by email!
Name
*
Email Address
*
Class Of
*
(Select One)
1965
1970
1975
1980
1985
1990
1995
2000
2005
2010
2015
2020
Campus
*
(Select One)
MCW-Central Wisconsin
MCW-Green Bay
MCW-Milwaukee
Degree
(Select One)
Doctor of Medicine - MD
Doctor of Pharmacy - PharmD
Mobile Phone
Home Address
Home Phone
Business Name
Business Address
Business Phone
Spouse/Partner
Children (names and ages)
Grandchildren (names and ages)
Career Details
Interests and Hobbies
Travel Highlights
Favorite memory from your time as a student
What experiences have most changed your life since graduation?
What significant health developments have you witnessed during your career that completely changed the way you approach your work?
Words of Wisdom
Share photos of you and your family!
Upload a Photo
Email: To send multiple digital photos (JPEG preferred) send to alumni@mcw.edu.
Mail: To send multiple photos, mail to MCW Office of Alumni Relations 8701 Watertown Plank Road Milwaukee, WI 53226