2023-24 MSUBA Membership Form

2023-24 MSUBA Membership Form
Basic Information
Name*

First NameLast Name
Spouse Name (if paying for joint membership)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Alumni Information
What year did you graduate?
What degree did you earn/are you pursuing?

BachelorsMastersTerminal (PhD, MD, JD, etc.)Not ApplicableOther
What is/was your major?
What chapter are you within 50 miles of and/or would like to be associated with?*

STOP!!! RECENT GRADS PLEASE READ!!!
Are you a Spring, Summer, or Fall 2023 graduate? If so, please click the below link to sign up for your COMPLIMENTARY ONE YEAR MEMBERSHIP.

CLICK HERE

All others, please proceed to the next screen to select your membership level and your chapter dues (if applicable).

Basic Information