FIU Museums Insiders Program Form

Name Name First Last
FIU Email
Preferred or Personal Email
Panther ID #
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Intended Major
I am currently . . .

I am currently . . . An undergraduate student A graduate student
Expected Graduation Date Expected Graduation Date / MM / DD YYYY
I'd like my membership card to display my pronouns.
How did you hear about the Insiders program?

How did you hear about the Insiders program? Through FIU faculty, an administrator, or a department Word of mouth (fellow student) Graham Center ad Printed ad (FIU Orientation Guide, Visitor Guide) Social media FIU.edu JMOF, Frost, or Wolfsonian website JMOF, Frost, or Wolfsonian eblast Other Other
By clicking here, I confirm that I opt in to FIU communications, to include, but not limited to, FIU External Relations, FIU Foundation, FIU Alumni Relations & Annual Giving, and other FIU departments.

By clicking here, I confirm that I opt in to FIU communications, to include, but not limited to, FIU External Relations, FIU Foundation, FIU Alumni Relations & Annual Giving, and other FIU departments. I agree.