IOU Student membership
To apply for student membership at the IOU, please provide the following information as pdf document with the required information. Please find a sample form below. Please note: Student membership will only be possible after being approved by the IOU committee.
Student Information:
Last Name and middle initial:
First Name:
Nick Name (if any):
Degrees earned:
Degree sought:
Estimated graduation year:
Program enrolled in:
Institution:
Department:
Street Address:
Building Number:
City, State, Zip, Mailing Code:
Country:
Office Phone Number:
Email address:
url of web page:
CV and publication list (or web page address)
Information of academic advisor:
Last Name and middle initial:
First Name:
Nick Name (if any):
Title:
Institution:
Department:
Street Address:
Building Number:
City, State, Zip, Mailing Code:
Country:
Office Phone Number:
Email address:|
Web page address
I certify that the above student is enrolled in B.S., M.S., or Ph.D. program (circle the appropriate) under my supervision.
Signature:
Date and place: