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APPLICATION FOR GENERAL MEMBERSHIP

 

 * = Required Field
 * Semester:  
                                                                                

 * Year:  
     
 
 * First Name:      * Last Name:    M.I.:    
 
 Nickname:    
 
 * Date of
   Birth:
  mm/dd/yyyy  
 
 * Phone
   Number: 
  999-999-9999  
 
 * Email
   Address: 
   
 
 Shirt Size:  
                                                                                
 
 Sweatshirt Size:  
                                                           
 

Please indicate which club/organization you would like to join by checking all boxes that apply.

     
     
     
     
     
     
     
     
     
     
 

 

 

 

*Applicants MUST maintain a minimum GPA of 2.0 and be enrolled in at least 6 credit hours per semester*
Upon submission, this form will be transmitted to the Office of Student Life in room B-240
For questions, please call (708) 456-0300 ext. 3221