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 ($275)  Renewal ($225)
Male  Female
Address Information
Additional Member (Partner)
Yes  No
New ($250)  Renewal ($205)
 x $275.00 =  
 x $225.00 =