illiAAC Membership Form 2021-2022
illiAAC Membership Form 2021-2022
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illiAAC website
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1. Last Name
Please be sure to visit the
illiAAC website
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2. First Name
3. UIUC Email
4. Job Title
5. Current Department or Unit
6. Total Number of Years at the University of Illinois
7. Number of Years in Higher Education
8. Membership Type
Renewal
New Member
9. Current Role (choose all that apply)
Academic Affairs
Student Affairs
Departmental Administration
College Administration
Campus Administration
Career Services
10. Who do you work with primarily?
Undergraduate Students
Graduate Students
Both
11. Are you a member of any of the following professional organizations? (choose all that apply)
ILACADA
NACADA
NASPA
Other
12. If you marked "other" in question 11, please list professional organization.
13. illiAAC Membership Dues (2021-2022) -- $20.00
Check -- make checks payable to illiAAC and mail to/drop off: Shanicka Burdine, 807 S. Wright Street, Floor 5 M/C 317 Champaign, IL 61820
Pay Later - Please contact Shanicka Burdine, burdine2@illinois.edu, or Clare Pratt, cmpratt@illinois.edu to make payment arrangements.
14. As a paying member of illiAAC, you are also invited to participate in the Illinois Graduate Professionals Association (iGPA). The focus of iGPA is professional development for those who work with graduate students. Would you also like to join/continue membership in iGPA?
Yes, renewal
Yes, first-time
No thanks
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