Membership Application
Although many of these fields aren't required, it does help us better understand the Penn State population that we serve. Please consider providing as much information as possible.
Email *
What type of membership have you decided on? *
Is this a new application or a renewal? *
First Name *
Last Name *
For Joint or Family Application, please provide the names of all other applicants. Single Applicants enter NA for Not Applicable. *
Street Address
City
State
Zip Code
Phone Number in (XXX) XXX-XXXX format as in (814) 867-5309
Where do you work? (City, State)
What is/was your occupation?
Relationship
Are you a member of the Penn State Alumni Association?
Clear selection
Are you a member of the Nittany Lion Club?
Clear selection
Graduation Year
Campus Attended
Academic College
PSU related Clubs, Sports, Greek, other Chapters, or AIG Affiliations
Interests
If not already a subscriber, can we add you to our mailing list?
Clear selection
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