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Wayne State University School of Medicine
 

SOM Home > Office of Student Affairs > General Programs > Academic Regalia Order Form

 

Academic Regalia Order Form

Please complete the entire form. All fields must be completed or academic regalia cannot be ordered.

Any questions, please email jlundsted@med.wayne.edu or call 313-577-1463.

**All Fields Are Required


Name:              

Email:               

Department:      

Telephone #:     

I have my own academic regalia
Please order academic regalia for me

Male    Female

Jacket or Dress Size:   

Height:   

Cap Size:       or inches   
(If cap size is not known, please measure head circumference with a tape measure and include that information)


The information listed below must be complete or the appropriate "hood" from your conferring institution cannot be ordered and a WSU hood will be substituted.

Degree:   M.D. D.O.    Ph.D.

Degree Granted from:          School:

                                        State: