The Hellenic Student Association of NJIT

Membership Application

 

Name:  _________________________________________

 

Department:     ___________________________________

 

Academic Status:          Fr      Soph      Jr      Sr      Grad

 

Expected Graduation Date:  _________________________

 

Mailing Address:     ________________________________

_______________________________________________

 

E-mail Address: ________________________________

 

Date:    _____________      Signature:  _______________