12th Can Membership Form
The 12th Can does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.
Email address *
Name (First & Last) *
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Untitled Title
Cell Phone # *
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UIN *
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Class Year *
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T-Shirt Size *
Major
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Birthday
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Are you a returning member? *
How did you find out about The 12th Can?
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Why are you interested in joining The 12th Can?
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