STU-DENT REGISTRATION FORM

Please note: This form is for NON-NYU Students. Please do not use this form if you are currently an NYU Student.

Personal Information
New ($240)  Renewal ($195)
Male  Female
Address Information

Additional Member (Partner)
Yes  No
New ($240)  Renewal ($195)

 x $240.00 =  
 x $195.00 =