AMSA 2022-2023 Local Application

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The University of California, Merced Chapter

Please fill out as much information as possible as this application is used to guide funds toward workshops, events, etc, so please fill it out to the best of your ability.

If you have any questions feel free to email our Vice President of Membership Kalie Vang at amsaucm.vpm@gmail.com

General Information

First Name *

Last Name *

UCM Email *

UCM ID *

Phone Number *

Do you have an AMSA National ID? *

Yes

No, I currently have a temporary AMSA ID

No, I am not yet registered with AMSA National

Class Standing *

First Year

Second Year

Third Year

Fourth Year

Fifth Year +

Major *

Minor

Are you a Transfer Student? *

Yes

Shirt Size *

XXL

If you have an AMSA National ID, please enter it below

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