AMSA Fall 2019 Local Application
The University of California, Merced Chapter

Please fill out as much information as possible as this application is used to guide funds toward workshops, events, etc, so please fill it out to the best of your ability. Please use correct grammar and spelling (we have had instances of people misspelling their name/email and or not capitalizing their name properly which leads to complications on this form)

If you have any questions feel free to email our Vice President of Membership Kyle Rekedal at:
General Information
First Name *
Your answer
Last Name *
Your answer
UCM Email *
Your answer
Your answer
Phone Number *
Your answer
Do you have an AMSA National ID? *
Class Standing *
Major *
Your answer
Your answer
Are you a Transfer Student? *
Shirt Size *
Member Interests
Are you a new or returning member? *
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