GOSUMEC Foundation

 I'm going to say thank you for taking just two minutes to fill out this quick survey.

The objective of this form is to connect with each other and the alma mater. Build & strengthen our relationship with Gosumec Alumni Association, GAA (GSMC & KEMH). 

This information will be secure with GAA and Gosumec Foundation to allow us to reach out to you in ways that you can help. 

Introducing our alumni engagement tool - a secure web-based platform connecting global alumni. Accessible on mobile phones, it fosters meaningful interactions among our community.

Join us and stay connected! Looking forward to Gosumecs' supporting our Mission to "Connect, Contribute & Engage."

Sanjay Bindra, MD

President, Gosumec Foundation

Email: gosumecfounder@gmail.com

https://gosumec.org

Sign in to Google to save your progress. Learn more
Email *
Country of Residence: +Country Code *
If Other, Submit Country of Residence: +Country Code
Mobile Number, no dashes (exclude country code)

 *
Your First name

 *
Your last name *
Your last name when you were at GSMC/KEMH (fill only if different from the above)
City (do NOT include state) *
State *
Zip code/Postal Code *
Year when you first joined GSMC/KEMH *
The course/s you did at GSMC/KEMH (check ALL applicable) *
Required
What is your current speciality of practice (if retired, pl. mention that) *
Are you still employed at GSMC/KEMH?
Clear selection
How would like to help ( check all applicable) *
Required
Would you like to be part of GOSUMEC WhatsApp Community *
Would you like to become a member of  Gosumec Alumni Association (GAA) at GSMC/KEMH? *
What activities would you like organized by GOSUMEC Alumni Association (GAA) at GSMC/KEMH (check all applicable)?
 *
Required
Comments/Suggestions/Feedback
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms