BSO Membership Application
Name
First and Last Name
Your answer
Address
Full Address, Street, City, State, and Zip Code
Your answer
Mailing Address
Full Address, Street, City, State, and Zip Code
Your answer
Contact Number
Example: (xxx)-xxx-xxx
Your answer
RebelMail Email Address
Your answer
Preferred Email Address
Your answer
NSHE ID#
Can be located on the front of your Rebelcard
Your answer
Classification
What year are you in school?
Required
Major
Area of study in school
Your answer
Minor
Your answer
Are you affiliated with any other Organizations on campus?
If yes, which ones?
Your answer
Shirt Size
I, do hereby, certify that all of the above information is true. I understand that submitting fraudulent information will affect my membership into the Black Student Organization. Lastly, I understand that my ā€œLā€ number will not be used for anything other than to verify my student status; anything else requires my written consent.
If you agree, please check the box marked yes. If you do not agree, please close your browser.
Required
Digital Signature
Please type your name in the box provided below. This will authenticate your application. By typing your name here, you are digitally signing your application for membership with the Black Student Organization.
Your answer
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