View source for Forms/Membership Application

Online Membership Application

This form is meant to be the online version of our paper membership application.

Filling out this form is only part of the membership process; please refer to our [[policy/Admissions|Admissions Policy]] for the full procedure.

Before filling out this application, please be sure to read the [[policy/Community Agreement|Community Agreement]], the [[policy/Space Rules|Space Rules]], and the [[policy/Bylaws|Bylaws]], and make sure you are comfortable agreeing with these terms.

{| class="wikitable"
! The online form is broken due to wiki migration. It will be fixed ASAP, but please use the [[Forms/PDFs|PDF versions]] until then.

The text below is kept for reference
|}

<form>
action mail board@hacksburg.org
thanks "Thanks for your interest in becoming a member! The Board of Directors will receive your application shortly. In the meantime, now would be a good time to fill out the liability waiver and arrange payment of your membership dues."

fieldset "Personal information"
textbox "Name"
date "Date of Birth"
textbox "Address 1"
textbox "Address 2" !
textbox "City"
textbox "State"
textbox "ZIP Code" /\d{5}([ \-]\d{4})?/ "**You must enter a valid ZIP code here."

fieldset "Contact Info"
textbox "Phone Number"
yesno "This phone number can receive text messages" =phone_1_sms !phone_1_no_sms
textbox "Alternate Phone Number" !
yesno "This phone number can receive text messages" =phone_2_sms !phone_2_no_sms
email "Email Address"
email "Alternate Email Address" !
radio "Do you have an ACTIVE Hokie Passport? (active VT student/faculty/staff or CRC employee)" "Yes|No"

fieldset "Verifications"
static "To be considered for membership, you must affirm that all the statements made on this form are true and correct, and to agree to the terms of membership for Hacksburg. Please answer the questions below."

textbox "Do you affirm that the info on this form true and correct?"/^Yes$/ "**You must affirm this information is correct to be a member of Hacksburg."
textbox "Do you agree to be bound by the terms of the Hacksburg Community Agreement?"/^Yes$/ "**You must agree to this to be a member of Hacksburg."
textbox "Will you comply with all Hacksburg policies during your membership?"/^Yes$/ "**You must agree to this to be a member of Hacksburg."
textbox "Do you consent to being contacted by Hacksburg for official business?"/^Yes$/ "**You must consent to this to be a member of Hacksburg."

submit "Submit Membership Application"
</form>