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Complete an interest form

To take part in this program, you must be a dues-paying union member or family member who has an associate degree or at least 60 hours of college credit.
Student Contact Information
Name*
First Last
Email*
Phone*
Street address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Has the COVID-19 crisis affected you or a family member's employment?
- YES
- NO
Program of interest
Have you earned an Associate Degree, or more than 60 transferable credits, in the Bachelor's Degree Completion subject that interest you?*
- YES
- NO
Confirm the subject.
- Business Management
- Teacher Education
- Criminal Justice
- Other
Please list the subject.
Are you the active union member?*
- Yes
- No
What is your or the AFSCME member's status with the union?*
Union Member's Information
Name of AFSCME Member*
First Last
Your relationship to member:
What is the member's AFSCME membership number?
Council number?
Local number?
Where does the union member work?
Send Me Email Updates
- Yes, send me e-mail updates about union benefits and discounts.
Email
This field is for validation purposes and should be left unchanged.

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