UGapply | National Institute of Science

Last Name

First Name

Middle Name

Mailing Address

Permanent Address(if different from above)

Date of Birth

Place of Birth

Phone Number

Major

No. of hours in major

Universities Attended

Career Field

New Members

I wish to become a member of national organization of NIS

$35.00 for membership fee(Nat'l),includes pin

Continuing Members

If you are already a member then please pay dues for calender year

$10.00 for calender year

Campus NIS Clubs

I want a university NIS affiliation,but there is no NIS club on my campus.

Please send material to me or an NIS faculty member the NIS Organizer packet to begin a NIS club on my campus.The faculty name and address:-

Name

Address

Institution

Undergraduate Membership Registration