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    UB SPPS Dean's Alumni Ambassador Program

    The UB School of Pharmacy and Pharmaceutical Sciences is seeking successful SPPS alumni to share their experiences and insights regarding SPPS with students who may be exploring our programs. By helping prospective and newly accepted students to navigate questions surrounding the enrollment process and providing insights into the student experience, alumni will help to build and strengthen the SPPS community.

    If you're interested in volunteering, submit this form and we'll be in touch! If you do not receive an immediate confirmation, check your spam folder. Questions? Contact Jennifer Rosenberg, Associate Dean for Student Success & Engagement, jmr16@buffalo.edu

    *This form is for SPPS alumni only! Prospective students interested in learning more about the UB School of Pharmacy and Pharmaceutical Sciences should use this: SPPS Information Request Form

    Mailing Address
    Mailing Address
    Which program(s) did you complete in the School of Pharmacy and Pharmaceutical Sciences?
    Which program(s) did you complete in the School of Pharmacy and Pharmaceutical Sciences?
    Which volunteer options are you interested in?
    Which volunteer options are you interested in?
    Would you like to be a mentor for students Underrepresented in Pharmacy (UIP)?
    Would you like to be a mentor for students Underrepresented in Pharmacy (UIP)?
    Dean’s Student and Alumni Ambassador Program Confidentiality Agreement

    As a current Dean’s Student (DSA) or Alumni Ambassador (DAA) for the University at Buffalo School of Pharmacy and Pharmaceutical Sciences, I understand and agree to the following conditions and responsibilities of my role:

    1. I may gain access to sensitive or confidential information and records that may be protected from disclosure by federal or state law.  Examples include education records protected under the Family Educational Rights and Privacy Act of 1974 (FERPA) I understand that unauthorized disclosure of such ‘protected information’ can adversely impact the University, individual persons, or affiliated organizations.
    2. I will treat all information accessible to me in the performance of my duties as ‘protected information’, regardless of its format (e.g., electronic, paper, oral), unless and until advised otherwise by the SPPS Office of Student Success and Engagement. I will use ‘protected information’ for the sole purpose of performing tasks associated with my role and will not disclose such information to anyone without prior authorization from SPPS Office of Student Success and Engagement. I will not duplicate or allow anyone else to duplicate ‘protected information’ other than what is required in the regular performance of my volunteer tasks.
    3. I will not alter, delete, or enter fraudulent information into any academic, financial, or other educational records pertaining to me.
    4. I shall immediately report to the SPPS Office of Student Success and Engagement any unauthorized use, duplication, or disclosure of ‘protected information’.

    I am aware that failure to adhere to any of the conditions and responsibilities highlighted above will subject me to disciplinary action that may result in prosecution through appropriate University judicial processes, discharge from the ambassador program, expulsion from the University, and civil and criminal legal sanctions.

    Today's Date
    Today's Date