CANSBE Jr. Membership Form

🌟 Central Alabama NSBE Jr Membership Form 🌟

Welcome to NSBE Jr! 🚀We’re excited to have your student become a member of our family of future engineers, scientists, and leaders. Please complete this form to begin their membership.
👩🏾👨🏾 Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
👧🏾👦🏾 Student Information
How many students are you registering for NSBE Jr.?
- Student's Name
  
  First NameLast Name
- Age
- Grade Level
- School
- Student's Name
  
  First NameLast Name
- Age
- Grade Level
- School
- Student's Name
  
  First NameLast Name
- Age
- Grade Level
- School
- Student's Name
  
  First NameLast Name
- Age
- Grade Level
- School
- Student's Name
  
  First NameLast Name
- Age
- Grade Level
- School
- List any restrictions or concerns below
- Which areas of S.T.E.M. does your student enjoy most? (Check all that apply)
- Central Alabama NSBE Jr annual dues are $10.
  
  💡 This amount covers the NSBE Jr year (September – May) and helps support STEM project supplies and chapter events for our students.
  
  Payment Options:
  
  We kindly ask that you cover any processing fees associated with electronic payments.
  
  💳 PayPal: Payment Link
  
  Be sure to select NSBE Jr Membership ($10) when submitting your payment.
  
  💚 Cash App: $NSBEMGM
  Please include CANSBEJr – Student Name(s) in the payment note.
  
  💵 Cash: You may also pay $10 in cash at the next S.T.E.M. Meet-Up.
- ✅ Before submitting, please confirm:
Should be Empty:

🌟 Central Alabama NSBE Jr Membership Form 🌟