Theta Chapter Member Application
Instructions:
Please print, complete, and submit to the chapter membership chair. For information about qualifications for membership in The Delta Kappa Gamma Society International, refer to sections on membership in the Constitution and the International Standing Rules.
Please print, complete, and submit to the chapter membership chair. For information about qualifications for membership in The Delta Kappa Gamma Society International, refer to sections on membership in the Constitution and the International Standing Rules.
Name of person recommending prospect:
Name of New Member:
Address:
Phone Numbers: Home: Cell:
Preferred E-mail: ___________________________________
Current position title: _______________________________________
Employer: _______________________________________
Highest educational degree granted: _______________ Year: __________ Field: ____________________
What do you want others to know about you as an Educator?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What else do you want others to know about you? (Such as personal interests, hobbies, community involvement, etc.)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature of Applicant: Date of Initiation: TBA
Name of New Member:
Address:
Phone Numbers: Home: Cell:
Preferred E-mail: ___________________________________
Current position title: _______________________________________
Employer: _______________________________________
Highest educational degree granted: _______________ Year: __________ Field: ____________________
What do you want others to know about you as an Educator?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What else do you want others to know about you? (Such as personal interests, hobbies, community involvement, etc.)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature of Applicant: Date of Initiation: TBA