Chatham University Affiliate Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The Osher Lifelong Learning Institute at CMU is pleased to announce that the organization is now accepting immediate membership from the Chatham University community. Affiliates are restricted to:

- Active Employees (current and up to 1 year after retirement) are defined as current faculty or staff who are "medical benefits eligible" and their spouse or legal domestic partner.

- Former Employees are defined as former faculty or staff and their spouse or legal domestic partner who would be "medical benefits eligible" or former faculty or staff that has at least 10 years of cumulative service with Chatham.

- Chatham Alum must have graduated from Chatham with an undergraduate or graduate degree. Parents /spouse of Chatham Alum are also invited to membership.

Please allow 2 months to process an affiliate application.

If you are not a Chatham Affiliate, please complete this form instead: https://goo.gl/forms/nXrx5aDnz66PzgEr1

Email *

Important Email Notice

Verizon.net and Aol.com email addresses are having issues with distribution lists, meaning you will not receive notices from Osher at CMU.

We strongly suggest obtaining a new email address from Gmail or Outlook.

First name *

Last name *

Birthdate *

YYYY

Mobile number *

Secondary phone number (optional)

Street address (including apartment/unit #) *

City *

State *

Zip code *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms