Associate Membership Application

APPLICATIONS ARE DUE BY FRIDAY, January 25, 2019 by 11:59 PM.

***APPLICATION IS NOW CLOSED. PLEASE CHECK BACK IN AUGUST FOR FALL APPLICATIONS***

Name *
Name
Preferred first and last name for membership certificate
Address *
Address
Phone *
Phone
Major *
Check all that apply
By signing below, I certify all information is true and correct to the best of my knowledge.