SRT Application Form

"*" indicates required fields

NOTE: To be an official member of the chapter’s SRT, STARFLEET membership is required;
You must also affiliate with the STARFLEET Sciences Auxiliary in the database AND be a member of STARFLEET Sciences

Lead Researcher (LR) (SRT Lead)*

Name

LR SCC#*

LR Email Address*

Lead Researcher Assistant (LRA)

Name

LRA SCC#

LRA Email Address

Additional members (please provide Names and SCC #)

SRT Motto (optional)

SRT Nickname (optional)

SRT Logo (optional) - Please attach to application

Max. file size: 98 MB.

Chapter and NCC# (the NCC# is your SRT#)*

Have you discussed with and received permission from your Chapter CO*

yes