MEMBER SIGNUP

*indicates required field

E-Mail Address* Password
First Name* Last Name*
Member Status* New Renewal of Membership
Your Current Mailing Address
Street* City*
State or Province* Zip or Postal Code*
Country Current Phone No. ( )-
 
Permanent Mail Address (If different from current)
Same as Current Mailing Address
Street City
State or Province Zip or Postal Code
Country Permanent Phone ( )-
Permanent E-Mail Address
Gender Date of Birth
 
College/University*
Classification*
Ethnic Origin
If other - Ethnic Origin
Industry*
PAYMENT: (National Annual Dues are (U.S.) $ 25 per person for students)
 
Credit Card: *    
Amount to Be Charged: *    
Credit Card Number:*    
Expiration Date: * /    
CVV Number: *   (Security code from back of card)
Name on Credit Card: *    
 
RESUME PROFILE
Please upload current resume to complete the NSMH membership application. If you don't have your current resume you cannot proceed with completing your NSMH membership. If you are registering as a freshman and this is your first time applying for NSMH membership, please proceed and upload your resume within 30 days of membership processing.
 
Upload Resume*
.DOCX not allowed will cause error.
Please use .PDF or save as .DOC (Word 1993-2003)
 
 
Type the code shown*  Change Text
 

Contact The office to change any information you can not edit here.  Be sure to include your Member ID and your Name as it is shown above.

 6933 Commons Plaza, Suite 537
Chesterfield, VA 23832
Phone: (703) 549-9899
Fax: (703) 539-1049

memberportal@nsmh.org

 
 
Last updated, July 30th, 2008