MBS Online Membership Registration Form

* Mandatory Fields

First Name:*
Middle Name:
Last Name:*
E-mail Address:*

Status:*	Undergraduate Graduate Faculty/Staff Other
Major/Department:*
Expected Graduation:

Other Family Member:	(First Name, Last Name)
Other Family Member:	(First Name, Last Name)

Local Address:*
City:*
State:*
Zip Code:*

Address outside U.S. (If any)
City:
State/Province:
Zip Code:
Country:

Home Phone:
Work Phone:
Cell Phone:

Interests:
University you Graduated in Brazil:

Check this box if you would also like to subscribe to our e-list.

MBS membership is free and restricted to the University of Maryland community.

The information collected will not be sold to any third party for any reason and will only be accessible to MBS officers.

If you don't feel comfortable submitting the online form, please download the paper application below and mail the form to the address specified in the paper form:

MBS paper application form