Register/Application

First Name:*		Last Name:*
Email Address:*
Home Phone:*		Work Phone:*
Cell Phone:*
GPA Overall:*		GPA Major:*
TShirt Size ($10.00 extra fee)	Small Medium Large XL No T-shirt Please
Class Standing:*	Undergraduate Graduate Professional	Membership Status:*	Candidate Member
Gender:*	Male Female	Ethnicity:*	Asian African American Hispanic Native American White International
Major1:*		Major2:
Address1:*
City:*			Also remember to pay your dues to the treasurer. Once your dues have cleared, your account will be activated.
State:*
Zip:*
User Name:*
Password:*	Use only letters, numbers, and the underscore. Must be between 4 and 20 characters long.
Confirm Password:*

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