Membership Request Form - Post Image Cluster
* Required
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone
*
Your answer
Office Phone Extension
Your answer
Employee ID
Your answer
Student ID
Your answer
Membership Type
*
Regular Member (Full or Part-time Faculty, Postdoc)
Student Member (Under supervision of a Regular Member)
Research Assistant (Under supervision of a Regular Member)
Affiliate Member (Sponsored by a Regular Member)
Visiting Artist / Scholar (Invited by a Regular Member)
Student Program Level
Undergraduate
Masters
Doctoral
Clear selection
Faculty Academic Rank
Your answer
Program
Your answer
Department
Your answer
Faculty
Your answer
Primary Supervisor Name
Your answer
End of Program Date
MM
/
DD
/
YYYY
VR Member
VR Member
N/A
Clear selection
Briefly describe your current interests and project(s) and how it will benefit or contribute to the cluster.
*
Your answer
Please provide a short biography or artist statement.
*
Your answer
Please provide the link to your professional website, if applicable.
Your answer
In addition to the rights and privileges of membership, members are expected to actively engage with the cluster by initiating collaborations, offering activities available to all cluster members, and care for the equipment. Members are also expected to keep all common spaces clean. Please indicate how you intend to contribute:
*
Giving a thematic presentation or artist talk
Hosting a free workshop of interest to cluster members or the public
Attend all cluster activities and contribute to administrative duties
Other:
Required
Please indicate why you would like to join the cluster:
*
Student scholarships
Interested in research being conducted by other cluster members
Want to be part of a creative community involving knowledge exchange
Use of cluster equipment
Other:
Required
Other cluster of which you are a member (if any):
Your answer
Members of multiple clusters must declare a Primary Cluster Affiliation. Will Post Image be your Primary Cluster?
Yes
No
Clear selection
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