UAB Student Media Interest Form

First Name(*)
Please let us know your first name.

Last Name(*)
Please let us know your last name.

Blazer ID(*)
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Email Address(*)
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example: yourblazerID@uab.edu

Phone number(*)
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Which organization(s) would you like to join?(*)

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List any specific skills or interests
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How are you classified?(*)
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What is your major?(*)
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