Chapters Sign Up Form If you are interested in becoming a part of one of our existing chapters, please complete and submit the form below. If you meet the requirements to become a part of the chapter you selected, we will provide them with your information to get in touch! Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Gender*MaleFemaleNon-BinaryPrefer Not to AnswerDate of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Preferred Phone* Home Cell Work Phone Number*Email* UMR Chapters*Which UMR chapter would you like to join?George Mason UniversityUniversity of DelawareUniversity of North Carolina-CharlotteRutgers UniversityJohns Hopkins UniversityTemple UniversityMichigan State UniversityNew Jersey Institute of TechnologyUniversity of Minnesota-Twin CitiesUniversity of Texas-AustinUniversity of Texas-DallasUniversity of HoustonVanderbilt University*Are you a current student or graduate of the academic institution you selected?YesNo*Do you live in close enough proximity to the academic institution you selected to attend meetings and events in-person?YesNo*Are you in good academic and disciplinary standard with your academic institution?YesNoAcademic Year*What is your class standing as of the 2021 spring semester?FreshmanSophomoreJuniorSenior5th YearGraduate StudentExpected Graduation*Spring 2021Fall 2021Spring 2022Fall 2022Spring 2023Fall 2023Spring 2024OtherAreas of Study(You can choose multiple studies by holding the control/command button when selecting)HistoryLanguages and LinguisticsLiteraturePerforming ArtsPhilosophyReligionVisual ArtsAnthropologyArchaeologyArea StudiesCultural & Ethnic StudiesEconomicsGender & Sexuality StudiesGeographyPolitical SciencePsychologySociologySpace SciencesEarth SciencesLife SciencesChemistryPhysicsComputer SciencesLogicMathematicsStatisticsSystems ScienceAgricultureArchitecture & DesignBusinessDivinityEducationEngineeringEnvironmental Studies & ForestryFamily & Consumer ScienceHealth SciencesHuman Physical Performance & RecreationJournalism, Media Studies, & CommunicationLawLibrary & Museum StudiesMilitary SciencesPublic AdministrationSocial WorkTransportationOtherReferral Source*How did you hear about our organization and our chapters program? UMR Website Third-Party Website Social Media Fundraiser/Campaign/Event Word-of-Mouth (Friend, Family, Colleague) Mailer Advertisement Other