Membership Application ⇽ Collegiate

Uploading an image is mandatory

Please enter a first name

If you input more than 0 characters your First Name may not display properly

Please enter a last name

If you input more than 0 characters your Last Name may not display properly

Please enter a valid email address
e.g. john.doe@glueup.com

If you input more than 0 characters your Email may not display properly

Password must be a minimum of 8 characters and contain at least one upper case letter, one lower case letter, one number, and one special character(!"#$%&'()*+,-./\:;?@[]^_`{|}~=).

If you input more than 0 characters your Password may not display properly

Password must be a minimum of 8 characters and contain at least one upper case letter, one lower case letter, one number, and one special character(!"#$%&'()*+,-./\:;?@[]^_`{|}~=).

If you input more than 0 characters your Confirm password (at least 8 characters) may not display properly

Please enter a first name

If you input more than 0 characters your First Name may not display properly

Please enter a last name

If you input more than 0 characters your Last Name may not display properly

Please enter a valid email address
e.g. john.doe@glueup.com

If you input more than 0 characters your Email may not display properly

Please enter a valid phone number including country code

If you input more than 0 characters your Phone may not display properly

Please enter a valid date
e.g. mm/dd/yyyy, dd-mm-yyyy or yyyy-mm-dd

If you input more than 0 characters your Job Title may not display properly

Please select an option

If you input more than 0 characters your Address may not display properly

If you input more than 0 characters your State/Province may not display properly

Please Select Valid Province Value

If you input more than 0 characters your Postal Code/Zip Code may not display properly

If you input more than 0 characters your City may not display properly

Please enter a valid WhatsApp Phone Number

If you input more than 0 characters your WhatsApp or Telegram Number may not display properly

Please enter a valid LinkedIn link e.g. "https://www.linkedin.com/in/userid"

If you input more than 0 characters your LinkedIn Link may not display properly

Please enter a valid Instagram Link e.g. "https://www.instagram.com/username"

If you input more than 0 characters your Instagram Link may not display properly

Please enter a value for the other option. The value cannot exceed 255 characters.

Select one or more options

If you input more than 0 characters your Industry Events (Conferences/Summits) may not display properly

Please enter a valid email address
e.g. john.doe@glueup.com

If you input more than 0 characters your Company Email may not display properly

If you input more than 0 characters your Office Address may not display properly

Select one or more options

If you input more than 0 characters your Please indicate if you are a member of other associations such as: SPE, NSE, APWEN, EI, COREN, NAPE may not display properly

If you input more than 0 characters your Please specify who you are regulated by such as: NMDPRA, NUPRC NIPEX, if others, please specify may not display properly

Please upload a valid curriculum vitae (cv)- please upload your cv

If you input more than 0 characters your Name and Email of two Member Referees may not display properly

This checkbox is mandatory

If you input more than 0 characters your Email Address may not display properly

If you input more than 0 characters your Phone may not display properly

If you input more than 0 characters your Password may not display properly

Password must be a minimum of 8 characters and contain at least one upper case letter, one lower case letter, one number, and one special character(!"#$%&'()*+,-./\:;?@[]^_`{|}~=).

If you input more than 0 characters your New Password may not display properly

Please make sure this password matches the password above

If you input more than 0 characters your New Password may not display properly

Password must be a minimum of 8 characters and contain at least one upper case letter, one lower case letter, one number, and one special character(!"#$%&'()*+,-./\:;?@[]^_`{|}~=).

If you input more than 0 characters your New Password may not display properly

Please make sure this password matches the password above

If you input more than 0 characters your New Password may not display properly

Membership Refund Policy

Glue Up account creation information.

Please fill in your member application details.

Membership Refund Policy

Glue Up account creation information.

Please fill in your member application details.

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