USAS Local Affiliation
Interested in starting a USAS local on your campus or affiliating your local labor-solidarity organization? Please fill out this form so a USAS National staff member, Regional Organizer, or Coordinating Committee member can reach out!
Name of School *
Please write out the full name of your university or college.
Your answer
Name of Group *
Please write out the full name of your local organization.
Your answer
Top 3 Preferred Local Numbers *
Every USAS local is assigned an identifying number. List your top three preferred numbers (preferably in the range 11-200 and at maximum 3 digits). For example, "20, 199, 95". The Coordinating Committee will contact you to finalize your local number assignment.
Your answer
Contact #1
Main liaison for your group.
Name *
Your answer
Phone *
Your answer
Email *
Your answer
Contact #2
Other main liaison for your group.
Name *
Your answer
Phone *
Your answer
Email *
Your answer
Mailing Address
List an address for your group or one of its members so that we can mail you your local charter.
Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Are at least two members of your group already individual members of USAS? *
If not, you can sign up at http://usas.org/member
Required
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