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Alumni Library Privileges Information Form

Name:
*
Address:
*
City:
*
State:
*
Zip Code: *
Where did you obtain your O.D. degree?
Graduation Year:
Where did you attend a Residency Program?
Graduation Year:
Colleges Attended:
Graduation Year:
Degree(s)
Where did you obtain a Ph.D. (if applicable) or other advanced degrees:
Graduation Year:
Degree(s)
Email:
(If you have multiple accounts, please indicate which on you would like us to use)
*
Telephone (Daytime):
*
States where Licensed:
Materials will be delivered electronically when possible. For print documents, please indicate your preference for delivery:
Pickup at the Library  
Mail: (if address is different from the one above please provide)  
Email: (please provide current email address)
General areas of professional interest:

Questions: Please email us at: kohnlibrary-is@sunyopt.edu
The Harold Kohn Vision Science Library
SUNY College of Optometry
33 West 42nd Street
New York, New York 10036
212 938-5690