Chapters Sign Up Form

Chapters Sign Up Form

If you are interested in becoming a part of one of our existing chapters, please complete and submit the form below. If you meet the requirements to become a part of the chapter you selected, we will provide them with your information to get in touch!
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Name
Address
Preferred Phone
Which UMR chapter would you like to join?
Are you a current student or graduate of the academic institution you selected?
Do you live in close enough proximity to the academic institution you selected to attend meetings and events in-person?
Are you in good academic and disciplinary standard with your academic institution?
What is your class standing as of the 2021 spring semester?
(You can choose multiple countries by holding the control/command button when selecting)
(You can choose multiple countries by holding the control/command button when selecting)
Referral Source (How did you hear about our organization and our chapters program?)