SRT Application Form

"*" indicates required fields

NOTE: To be an official member of the chapter’s SRT, STARFLEET membership is required; the member must also affiliate with the STARFLEET Sciences Auxiliary in the database AND sign up for membership with STARFLEET Sciences (https://sciences.sfi.org/join-us/)

Lead Researcher (LR) (SRT Lead)*

Name

LR SCC#*

LR Email Address*

Lead Researcher Assistant (LRA)*

Name

LRA SCC#*

LRA Email Address*

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