1. Name:    

                2. Email:     

                3. Tel:         

                4. Are you an FIU student?
                   (If no go to question #7 )
                   Yes    No

                5. What is your major?
                   

                6. Are you a... Freshman Sophmore Junior Senior

                7. How did you hear about us?
                   

                8. Comments:
                   

You can also email us at adchapter@aol.com or gabyyyy@mac.com

Or contact our FIU Faculty Advisor Yolanda Cal caly@fiu.edu