*1.Contact Information(Required.)

First Name

Last Name

Email Address

Phone Number (Optional)

*2.Campus Information(Required.)

Title

Office/Department

Institution/University Name

*3.Mailing Address for Materials(Required.)

Name *

Company

Address *

Address 2

City/Town *

State/Province *

AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming

ZIP/Postal Code *

4.What promotional materials are you requesting?

CLS Program Flier (also includes CLS Spark)

CLS Spark Flier (specific to CLS Spark)

CLS Pens

CLS Stickers

Other promotional item

*5.Address Type(Required.)

Campus (Personal)

Campus (Departmental)

Home

Other (please specify)

6.Indicate the desired quantity of the materials requesting. Please note, while we will try to accommodate the amount requested, it may not be possible in some cases. 

7.Does your office use social media? We'd love to follow you!

Twitter

Facebook

Instagram

Does your institution have a CLS Campus Advisor?
Check here: https://clscholarship.org/universities

You can sign up to be an advisor or update your existing advisor contact information here at any time: http://www.clscholarship.org/advisors/sign-up

Serving as a CLS Campus Advisor ensures that you'll be the first to hear about our application launch, deadline, and available resources for students. 

Thank you for your continued support of the CLS Program.

- Caitlin Ting, Assistant Manager, Outreach & Selection