Chapters Creation Form If you are interested in applying to launch a chapter on your campus/in your community, please complete and submit the form below! We will reach out to those selected to set up a time to discuss next steps. Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Address Line 1CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryGender *GenderMaleFemalePrefer Not to AnswerDate / Time *Preferred Phone *HomeCellWorkPhone Number *Email * UMR Chapters Which UMR chapter would you like to join?UMR Chapters *College/University ChapterCommunity CenterAre you a current student or graduate of the academic institution you selected? *YesNoDo you live in close enough proximity to the academic institution you selected to attend meetings and events in-person? *YesNoAre you in good academic and disciplinary standard with your academic institution? *YesNoNot Applicable Academic Year What is your class standing as of the 2021 spring semester? Academic Year *FreshmanSophomoreJuniorSenior5th YearGraduateExpected Graduation *Expected GraduationSpring 2022Fall 2022Spring 2023Fall 2023Spring 2024Fall 2024Other Areas of Study (You can choose multiple countries by holding the control/command button when selecting)Areas of StudyHistoryLanguages and LinguisticsLiteraturePerforming ArtsPhilosophyReligionVisual ArtsAnthropologyArchaeologyArea StudiesCultural & Ethic StudiesEconomicsGender & Sexuality StudiesGeographyPolitical SciencePsychologySociologySpace SciencesEarth SciencesLife SciencesChemistryPhysicsComputer SciencesLogicMathematicsSystem ScienceAgriculture & DesignBusinessDivinityEducationEngineeringEnvironmental Studies & ForestryFamily & Consumer ScienceHealth SciencesHuman Physical Performance & RecreationJournalism Media Studies & CommunicationLawLibrary & Museum StudiesMilitary SciencePublic AdministrationSocial WorkTransportationOtherCurrent Employment StatusCurrent Employment StatusFull-TimePart-TimePer DiemTemporaryContractInternSeasonalUnemployed Job Industry (You can choose multiple countries by holding the control/command button when selecting)Job Industry *Accounting/FinanceAdvertising/Public RelationsAerospace/AviationArts/Entertainment/PublishingAutomotiveBanking/MortgageBusiness DevelopmentBusiness OpportunityClerical/AdministrativeConstruction/FacilitiesConsumer FoodsEducation/TrainingEnergy/UtilitiesEnergy/UtilitiesEngineeringGovernment/MilitaryGreenHealthcareHospitality/TravelHuman ResourcesInstallation/MaintenanceInsuranceInternetJob Search AidsLaw Enforcement/SecurityLegalManagement/ExecutiveManufacturing/OperationsMarketingNon-Profit/VolunteerPharmaceutical/BiotechProfessional ServicesQA/Quality ControlReal StateRestaurant/Food ServiceRetailSalesScience/ResearchSkilled LaborTechnologyTelecommunicationsTransport/LogisticsOtherReferral Source (How did you hear about our organization and our chapters program?) *UMR WebsiteThird-Party WebsiteSocial MediaFundraiser/Campaign/EventWord-of-Mouth (Friend, Family, Colleague)MailerAdvertisementOtherI'M INTERESTED IN STARTING A UMR CHAPTER!