Student Membership Fee Waiver Request
Name
*
First Name
Last Name(s)
Email
*
example@example.com
Are you connected with a Chapter? If so, which one?
Name of University
*
Expected Graduation Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Degree Level
*
Undergraduate First Year (freshman)
Undergraduate Second Year (sophomore)
Undergraduate Third Year (junior)
Undergraduate Fourth Year (senior)
Undergraduate Fifth+ Year
Graduate First Year
Graduate Second Year
PhD/Advanced Degree
How will this membership waiver support you? (select all that apply)
*
Scholarship Application
Conference and Career Expo
Local Chapter Events
Virtual Events and Programs
Joining a University Chapter
Networking
Professional Development
Job Search/Job Board
Other
Are you applying for a Prospanica Scholarship? (select all that apply)
Yes, National Scholarship
Yes, through Prospanica Philadephia/Pennsylvania
Not at this time
I would like to receive information about events, programs and resources via email.
Yes
No
Submit
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