Become an ACUPA Member

Simply fill out the form below to become a member.

NOTE: Please sign up for the ACUPA listserv prior to filling out this membership form. We verify that members are signed up on the listserv before adding to the membership list.

Institution: (required)
First Name: (required)
Last Name: (required)
Email: (required)
Phone:
Title:
Department:
Policy Website URL:

Check here if you agree that we may display your name, phone number and email address in the Online ACUPA Directory.

We do not share the ACUPA membership list with outside organizations or individuals.