EmailMe Form - Membership Application

Membership Application
Fill out the application. Send the $50 lifetime membership fee to Jan Byrd in the MBA office or mail it to:

MBAA
P.O. Box 44568
Lafayette, LA 70504

Name *

First and Last

Date *

YYYY

Address *

Street Address *

Address Line 2

City *

State / Province / Region *

Postal / Zip Code *

Country *

Phone Number *

###

####

Cell Number

###

####

Other

###

####

School Email Address *

Other Email Address *

Expected Date of Graduation *

Month/Year

Student Status *

Full time/Part time

Heath Care Option *

Yes

T-shirt size *

S/M/L/XL/XXL

What is your businiess background and/or your interests in the MBA program? *

Marketing, Management, etc.

Would you be interested in playing intramurals? If so, check the ones that interest you.

Basketball

Volleyball

Softball

Flag Football

Soccer

Other

If other, please list.

Other sports can be found on the Intramurals Website.

Would you be interested in working charity events? *

Yes

Would you like to order an MBAA polo shirt for an additional $26? *

Yes

If yes, polo shirt size

S/M/L/XL/XXL

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