Student Membership Form
Student membership is available only to full-time students with an active .edu email address.
Name
*
First Name
Middle Name
Last Name
Preferred Name
*
Email Address
*
example@example.edu
Student membership is available only to full-time students with an active .edu email address. Make sure you enter a valid .edu email address.
*
Whatsapp Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Institution Name
*
Study
*
Degree
*
Graduating Year
*
LinkedIn Profile URL
*
Have you ever attended an OPEN DC Annual Conference?
*
Please Select
Yes
No
Have you attended any other OPEN DC event within the last 24 months?
*
Please Select
Yes
No
How did you hear about OPEN DC?
*
0/100
Consent
*
I consent to pay $100.00 student membership fee annually.
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Payment
amount in the backend.
My Subscriptions
*
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Student Membership
$100.00
$
100.00
for each
year
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