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CONTACT INFO (required for all registrants)
First Name	Last Name
Maiden Name (if applicable)
Current Address		Apt.
City	State Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareColumbia (District of)FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming	Zipcode
Home Phone	Email Address
Is this your permanent address?
Membership Type Graduate I did not graduate from UMBC I am a current UMBC student UMBC faculty Friend of UMBC-MUN		Grad Year      1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Major
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Do you want to subscribe to the MUN Newsletter? Yes No
PERMANENT ADDRESS (complete if contact address is not your permanent address)
Permanent Address		Apt.
City	State Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareColumbia (District of)FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming	Zipcode
Phone
STUDENT INFORMATION (required for all student registrants)
Are you, or do you anticipate being a delegate for a conference this school year? Yes No
Can we contact your parents about MUN events? Yes No
If yes, what are your parents' names?
ALUMNI INFORMATION (required for all alumni registrants)
Current Employer (if applicable)		Job Title
Work Phone	Work Fax
Does your company match donations? Yes No Don't know What is company donation matching?