CLASS OF 1981 REGISTRATION FORM

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Reunion registration closes on Friday, May 27. Mail this form with your check, payable to Harvard Medical School, to HMS Alumni Office, 401 Park Drive, Suite 22 West, Boston, MA 02215. If you wish to pay by credit card, visit http://hms.harvard.edu/1981 to access the secure online registration link. You will need your HarvardKey to register online. Questions? Contact Emma Hastings at 617-384-8520 or by email at hmsalum@hms.harvard.edu. Please print clearly. CLASS OF 1981 REGISTRATION FORM First Name or Nickname (to appear on nametag): Last Name (to appear on nametag): Last Name at Graduation (if different than above): Daytime Phone Number: Email Address: Home City: Home State: HMS/HSDM Degree(s): HMS/HSDM Year(s): Guest First and Last Name (to appear on nametag): If your guest is an HMS or HSDM graduate, please indicate their class year: If you have more than one guest, please list them on the last page. I allow HMS/HSDM to: (If left blank, we will include your information.) List my name, city, state, and email address in the printed Directory of Attendees Yes No Add my name to the attendees list on the HMAA website Yes No Please indicate any mobility or access needs for you and/or your guest(s). Requests will be applied to all Reunion events. Please indicate any dietary restrictions for you and your guest(s). Requests will be applied to all Reunion events.

REGISTRATION FEE: Per Registration The registration fee covers alumna/us and all guests THURSDAY, JUNE 2: All-day Satellite Parking Parking is available in the Museum of Fine Arts, Boston Museum Road Garage (20 Museum Road), by advanced registration. Due to construction in the HMS Quad Garage, parking is NOT available on campus. Shuttle buses will provide transportation to campus. 8:30 9:30 a.m. Continental Breakfast 9:30 a.m. Noon (select one) Scientific Symposium HMS and Discovery: Award Winners Class of 1991 25 th Reunion Symposium Part I From Faking It to Making It: Look Where the New Pathway Has Taken Us! Noon 1:30 p.m. (tickets required) Lunch Family, Finance, and Philanthropy Seminar with Lunch (please select only one) 1:30 4 p.m. Class of 1991 25 th Reunion Symposium Part II From Faking It to Making It: Look Where the New Pathway Has Taken Us! 6 p.m. (tickets required) Reunion Gala Reception and Dinner Four Seasons Hotel Boston Reception and class photo followed by a private Class of 1981 dinner Pre-paid valet parking at Four Seasons Pre-order 8 10 class photo (taken at Gala) of cars 80 80 150 35 per car 25 per photo Page Sub : Page 2 of 5 HMS/HSDM REUNION: Class of 1981 Early Registration, 3/22/16

FRIDAY, JUNE 3: All-day Satellite Parking Parking is available in the Museum of Fine Arts, Boston Museum Road Garage (20 Museum Road), by advanced registration. Due to construction in the HMS Quad Garage, parking is NOT available on campus. Shuttle buses will provide transportation to campus. 8:30 9:30 a.m. Continental Breakfast 9:30 10 a.m. (select one) Annual Business Meeting Harvard Medical Alumni Association Annual Business Meeting Harvard Dental Alumni Association 10:15 11:45 a.m. (select one) HMS Alumni Day Symposium Medical Schools: Challenges and Opportunities HSDM Alumni Day Symposium A Tribute to Dr. Guralnick, DMD 41 Noon 12:30 p.m. (select one) HMS Dean s Address Dean Jeffrey S. Flier, MD HSDM State of the School Address Dean Bruce Donoff, DMD 67, MD 73 12:30 2 p.m. (tickets required) Lunch 2 p.m. (select one) Tour of the new HMS Clinical Skills Center Tour of HSDM Campus 3 5 p.m. Concert, Lecture and Reception: Music and Medicine: George Gershwin by Richard Kogan 6:30 p.m. Dinner at Clink Boston, MA of cars 95 Page Sub-: Page 3 of 5 HMS/HSDM REUNION: Class of 1981 Early Registration, 3/22/16

SATURDAY, JUNE 4: 9:30 a.m. Morning Gathering at the home of Robert Tepper Weston, MA 1:30 p.m. Afternoon Gathering at the home of David Torchiana Cape Cod, MA FAMILY AND FRIEND ACTIVITIES: THURSDAY, JUNE 2 1:30 p.m. Trolley Service to Shopping Boston s Back Bay 2 p.m. (tickets required) GENERAL Fenway ADMISSION Park Tour TICKETS: Adult Fenway Institute Park of Contemporary Tour Arts/Boston Child, ages 3-15 Museum of Fine Arts, Boston New England Aquarium Hosted by Robert Tepper Hosted by David Torchiana 20 15 per 15 ticket per 25 person per ticket 25 per ticket OPTIONAL: Reunion Report Voluntary Payment 55 Reunion Class Gift Page Sub-: TOTAL ENCLOSED (sum of all Page Sub-s) Page 4 of 5 HMS/HSDM REUNION: Class of 1981 Early Registration, 3/22/16

Mail this form with your check, payable to Harvard Medical School, to HMS Alumni Office, 401 Park Drive, Suite 22 West, Boston, MA 02215. Questions? Please contact Emma Hastings at (617) 384-8520 or by email at hmsalum@hms.harvard.edu. List additional guests from page one below. Page 5 of 5 HMS/HSDM REUNION: Class of 1981 Early Registration, 3/22/16