Application for Membership

Personal information
Name:	Suffix:
NU ID:
Campus address:	ZIP:
E-mail:	Phone:

Academic information
Standing:	Graduate student ( PhD / Masters / Other: ) School of Biological Sciences School of Veterinary Medicine and Biomedical Sciences Other: Undergraduate student Major: Exchange student College / Department / Program:
Advisor(s):	NCV faculty:	Yes / No

I understand and will comply with all University, Board of Regents, ASUN Student Government, Virology Student Association, state, and federal policies, rules, statues, and regulations as defined in the NU Book (RSO policy guide).

Name:	Date: