RSA Student Chapter Application/Renewal

RSA Student Chapter Application/Renewal Form
Requires a minimum of five paid-up student members (undergraduates may join at the same rate as graduate students) plus an RSA member as faculty sponsor.
Please Click here for Membership information.
SponsorName:
*RSA Member Number:
Mailing Address:
Add'l Address Info:
City:
State: Postal Code:
Email:
Work Phone:
Institutional Affiliation:
*if known
Proposed Chapter Name:
Student Members:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Please enter additional names in the comments section if needed.
Comments:
   - denotes required fields