UMD SACNAS Interest Form

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UMD SACNAS Interest Form

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First Name *

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Last Name *

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Email *

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UMD Affiliation

Undergraduate Student

Graduate Student

Post-Doc

Technician

Faculty

Staff

Other:

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Discipline

Physics

Chemistry

Engineering

Math

Computer Science

Life Sciences

Other:

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Sub-discipline (e.g. Entomology, Astronomy, Ecology)

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Are you interested in being involved in SACNAS leadership?

Yes

No

Maybe (I would like more information)

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