Club Interest Form

Tell us about your club so we can provide the support you need to fundraise and grow. Fields marked with * are required.

Contact Info

First name *

Last name *

Email *

Phone *

Club Name *

University / College Name *

Club Type *

Approximate Number of Members *

Club Website

Instagram

Facebook

What type of support are you looking for? *

Select all that apply.

Describe your fundraising idea or event *

Estimated Fundraising Goal (USD)

Proposed Timeline or Target Date *

Have you fundraised before? *

YesNo

How did you hear about AMSA? *

Do any current AMSA members attend your school? *

YesNoNot Sure

Are you interested in becoming an official AMSA chapter? *

YesNoMaybe