Membership Form - Black Graduate Student Association

Future Students

Undergraduate Students

Graduate Students

Parents & Family

Alumni

Faculty & Staff

Researchers

Patients

Colleges & Schools

BGSA Membership Form

Qualifications for the BGSA membership includes: being a part - or full-time graduate student enrolled at UAB with an active interest in contributing to the BGSA.

Please complete the following fields and press the submit button at the end of the form only once.

Title:(*)

Dr.

Mr.

Mrs.

Ms.

Invalid Input

Last Name:(*)

Invalid Input

First Name:(*)

Invalid Input

Graduate Program:(*)

Invalid Input

Degree Sought:(*)

Invalid Input

Expected Graduation (Semester/Year):(*)

Invalid Input

Undergraduate Institution:(*)

Invalid Input

Undergraduate Graduation Date:(*)

Invalid Input

Email Address:(*)

Invalid Input

Interest:

Please check this box if you would like to receive emails from BGSA of particular items of interest and upcoming BGSA sponsored or supported events.

Invalid Input

Brief description of items of interest:

Community Service and Networking

Fundraising

Blueprint Connect/Scholarship

Minority Achievement Gala

Invalid Input

Thank you for your interest and support of the UAB BGSA.

(*)

Invalid Input