GT BGSA Registration / Pay Dues

In order to become a member of the Georgia Institute of Technology Black Graduate Student Association, you must completely fill out the registration information. Once you complete the form, the form will prompt you to pay dues. The fields with asterisk(*) are required. After you submit the form, you will be added to our membership database and email list, and can pay your annual or semester dues online.

If you have already completed the form and want to pay dues. Please, click the below links:

Skip registration process and pay Yearly Dues | Skip registration process and pay Yearly Spousal Dues

Skip registration process and pay Fall Dues | Skip registration process and pay Fall Spousal Dues

Skip registration process and pay Spring Dues | Skip registration process and pay Spring Spousal Dues

Personal Information

GTID #*: Member Type:    Gender:  
First Name*: Last Name*:    MI:    Suffix:  
Date of Birth:         
Address*: Apt#:    
City*: State *: Zip *:
Primary Email*: Secondary Email:    
Home Phone #: Cellular Phone #:    
Work Phone #: Fax Number:    

Educational Background

Undergrad Institution*:

Undergrad Degree(s):

Graduation:  

Current/Terminal Georgia Tech Degree(s) Info: College:  

Major(s)*:

GT Entrance Date:  

GT Anticipated Graduation Date:  

Recent Employment (in or out of school)

Company #1:

Company #2:

Committee Interest (Select all that apply)

Information Technology Committee
Community Relations Committee
Fundraising Committee
Public Relations Committee
Recognition Night Committee
Social Networking Committee
University Relations Committee
[GT]2 Symposium Committee