Student Member Personal Info
full legal first, last
and if appropriate,
name. Do not use initials, nicknames or diminutives such as "Deb" or "Al" unless it is part of your legal given name. The name entered here will be recorded in the official SAMRT member register so
be sure to use proper case
. Once entered, you cannot change it without making application to the SAMRT Council. A Change of Name application form in PDF format is available for download by
Select your date of birth from the pop-up calendar. Click the "<" or ">" button to go backward or forward by months. Click the "<<" or ">>" button to go backward or forward by years. Click and hold any of these buttons for a drop-down selection. Click the close (X) button when the correct date is selected.
PRIMARY CONTACT INFORMATION Please provide your primary address information. This will be the main contact address to which official SAMRT written communication will be directed.
PRIMARY CONTACT INFORMATION Please indicate the type of address provided (Home or Work).
Please indicate the type of email address provided (Home or Work). The address provided will be the main email address to which official SAMRT communication will be addressed.
Login Information - create or edit your login credentials