New Member Middletown Form

Your Name(Required)

First Last

Ball State ID Number(Required)

BSU Email(Required)

Parent/Guardian #1

Parent/Guardian #1 Name(Required)

First Last

How are you related?(Required)

Parent/Guardian #1 Email(Required)

Parent/Guardian #1 Phone(Required)

Parent/Guardian #2

Parent/Guardian #2 Name(Required)

First Last

How are you related?(Required)

Parent/Guardian #2 Email(Required)

Parent/Guardian #2 Phone(Required)