Qualtrics Survey | Qualtrics Experience Management

Full Name - First Middle Last

EMPLID #

Yorkmail Address - @yorkmail.cuny.edu

Best Contact Phone #

I am interested in joining the follow club[s]:

ACTIVE - Clinical Laboratory Science
ACTIVE - Coalition for Students with Disabilities
ACTIVE - Cultural Diversity
ACTIVE - Haitian Student Association
ACTIVE - IMPACT Filipino
ACTIVE - Music
ACTIVE - Muslim Student Association
ACTIVE - National Association of Black Accountants
ACTIVE - Nursing
ACTIVE - Social Work Empowering & Encouraging Together
ACTIVE - Student Occupational Therapy Association
ACTIVE - Pandora's Box - Student Newspaper
PENDING - African Student Association
PENDING - Pre-Med
PENDING - ANIME
PENDING - Art Club
PENDING - Chorus
PENDING - Pre-Physicians Assistants' Club
PENDING - Pre-Veterinarian Club
PENDING - International Student Society
PENDING - S.E.E.K. Society
PENDING - Future Teachers
INACTIVE - Cybersecurity
INACTIVE - Fashion Society
INACTIVE - Cardinal Aviators
INACTIVE - Red Shoes Dance Team
INACTIVE - Sexuality & Gender Acceptance
INACTIVE - Photography Club
INACTIVE - Anime Club
INACTIVE - Pre-Law Society
INACTIVE - Veterans Club
INACTIVE - Entrepreneurship Club

I understand that by joining this club I will receive notices about upcoming event and programs. I commit to being actively engaged in this student led community and will, AT MINIMUM, participate in 3 in-person meetings per semester to maintain active membership.

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