If you have any questions about our club please don't hesitate to e-mail us. Once you have decided to join our club please use the application below or print out this word document.

Membership Application – Effective till December 2007

General Information

Name _________________________ Panther I.D. ______________________

Address ________________________________________________________

City ___________ State ___________________ Zip Code _______________

Home Phone (      ) ______________     Mobile Phone (      )    _________________ 

Work Phone (      )___________________         Email _______________________

Major(s) _______________ Graduation date ____________________

current class status _______________ Nationality _____________

Why do you want to join MAC?________________________________________

How do you plan (what will you contribute) to become an active member? ___________

________________________________________________________________

Committee Preferences

Please select a committee that you would like to join for the Fall 2005 semester.

___Arts ___Community Service ___Fundraising ___Historian ___Leadership

___Special events (Camboulay) ___Sports _____Other

Personal Statement

I, __________________ promise to promote a multicultural environment wherever I go and 
contribute to the Multicultural Awareness club in whichever way i can.


Signature_________________________________

For E-board Use Only

Date added to mailing list: ____________ Active member since: _______________