GENERAL/CONTACT INFORMATION Student First Name: Student Last Name: Email: Primary Phone: School Mailing Address: Address 2: City: State: --None-- ** - ** AB - Alberta AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona BC - British Columbia CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MB - Manitoba MD - Maryland ME - Maine MH - Marshall Islands MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NB - New Brunswick NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NL - Newfoundland and Labrador NM - New Mexico NS - Nova Scotia NSW - New South Wales NT - Northwest Territory NU - Nunavut NV - Nevada NY - New York OH - Ohio OK - Oklahoma ON - Ontario OR - Oregon PA - Pennsylvania PE - Prince Edward Island QC - Quebec Qld - Queensland RI - Rhode Island SA - South Australia SAN - Santiago SC - South Carolina SD - South Dakota SK - Saskatchewan Tas - Tasmania TN - Tennessee TX - Texas UT - Utah VA - Virginia Vic - Victoria VT - Vermont WA - Washington WA - Western Australia WI - Wisconsin WV - West Virginia WY - Wyoming YT - Yukon Zip Code: Birthdate: [MM/DD/YYYY] Gender: --None-- Female Male Non-Binary Prefer Not to Say Race/Ethnicity: --None-- African American Alaska Native American Indian Asian Hispanic Pacific Islander White Other* *If other, please add other race/ethnicity here: SCHOOL/DEGREE INFORMATION School Name: School Campus Location: Major: --None-- Accounting Business Administration Computer Science Creative Writing Cyber Security and Information Assurance Data Analytics Economics English Finance Hospitality and Tourism Management Information Technology Integrated Marketing Communications Journalism and Media Studies Legal Studies Marketing Musical Arts Other* *If other, please add other Major here: Minor: --None-- Accounting Business Administration Computer Science Creative Writing Cyber Security and Information Assurance Data Analytics Economics English Finance Hospitality and Tourism Management Information Technology Integrated Marketing Communications Legal Studies Marketing Musical Arts Writing Other* *If other, please add other Minor here: Degree Type: Graduate Undergraduate* *If Undergraduate, what Academic Year?: --None-- Freshman Sophomore Junior Senior Other* Not Applicable *If other, please add other Academic Year here: Anticipated Graduation Date: [MM/DD/YYYY] PARTNERSHIP OPTIONS Please be mindful of the partnership option you select as you will continue to have access to your Choose Chicago Student Partnership account and all of its resources for only six months past your graduation no matter the package you select. For example, do not select a 4-year membership if you are graduating one year from now. Select the partnership package which best aligns with your payment abilities and graduation plans. Partnerships can be renewed through your graduation date. Partnership Type: --None-- 1 Year Membership $15.00 2 Year Membership $30.00 3 Year Membership $45.00 4 Year Membership $60.00 Please select one TERMS OF AGREEMENT Student Partnership with Choose Chicago is held in the name of the student entered under the "Partner Information" section of this application. Any benefits of this partnership such as Choose Chicago reports, communications, and events are limited to that name. Student Partnership benefits do not begin until receipt of completed online application and full payment for your partnership investment. Your partnership dues payments must be made via a credit card. Checks and cash will not be accepted. Online applications are approved within 48 business hours unless otherwise noted. Choose Chicago reserves the absolute right to cancel an existing Student Partnership or reject a Student Partnership Application that it, in its sole judgment, deems inappropriate. Refunds for your Choose Chicago Student Partnership are not guaranteed and will be judged case by case. Your Partnership investment is deductible from income tax returns as a business expenditure. Pursuant to Section 6033 (e) of the internal Revenue Code, please be aware that an estimated 1.3% of your partnership dues are allocable to lobbying expenses. Pursuant to Section 162 (e) of the Code, this amount may not be deductible for income tax purposes. udf_3713 I have read, understood, and accept the above TERMS OF AGREEMENT Verification: Please enter the 4 character string shown in the box above. (Please enter the 4 character string shown in the box above.) Red fields are required. Submit Reset
