Rockford MakerSpace New Member Registration

Use this form to begin the process of applying for membership in Rockford MakerSpace. After submitting this form, you will need to visit Rockford MakerSpace during one of our Open Houses or regular Member Meetups and talk to one of our friendly Operations Committee leaders to complete your registration, pay the initial member fees^, then attend our next New Member Orientation session. (Check our calendar^ for dates and times.)

Required fields are   marked like this  .


Name:

Address:

Address 2:

City:   State:   Zip:

Email address:    

Phone:

Select a PIN (1 to 5 digits):

Emergency contact # 1:   Phone:   Relationship:

Emergency contact # 2:   Phone:   Relationship:

Do you have any allergies or medical conditions that we should inform first responders about in the event of an emergency?

Allergies: 256 characters remaining

Medical conditions: 256 characters remaining

If you were referred by a current member, please give us their name so we can thank them:

  New Member Bio  

This section is OPTIONAL, but we strongly encourage you to provide as much information as you are willing to provide. Anything you choose to provide here will be shared, along with your photo, with all our members. You will, likewise, be able to see the information they chose to share. You may find some common interests, or someone who can assist you.

Preferred Nickname:

How long have you lived in the Rockford area?

What do you like to make? 256 characters remaining

What would do you like to learn? 256 characters remaining

What, if anything, would do you be willing to teach? 256 characters remaining

Other comments about yourself: 256 characters remaining


Please verify you're a real person:

       
 

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