Membership Request Form - Post Image Cluster
First Name *
Last Name *
Email *
Phone *
Office Phone Extension
Employee ID
Student ID
Membership Type *
Student Program Level
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Faculty Academic Rank
Program
Department
Faculty
Primary Supervisor Name
End of Program Date
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/
DD
/
YYYY
VR Member
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Briefly describe your current interests and project(s) and how it will benefit or contribute to the cluster. *
Please provide a short biography or artist statement. *
Please provide the link to your professional website, if applicable.
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: *
Required
Please indicate why you would like to join the cluster: *
Required
Other cluster of which you are a member (if any):
Members of multiple clusters must declare a Primary Cluster Affiliation. Will Post Image be your Primary Cluster?
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