Phi Theta Kappa, Sigma Zeta Chapter, Application for Membership

Phi Theta Kappa/Sigma Zeta Chapter Application for Membership

Deadline for 2007-2008 memberships: May 16, 2008
Memberships after May 16, 2008 will be recorded for 2008-2009

Phi Theta Kappa (PTK) is the only honor society in the world for two-year colleges with goals of academic excellence. Its Hallmarks are Scholarship, Leadership, Fellowship, and Service to our campus and communities.

To determine if you are qualified to apply as an honor student, please answering these questions:

Yes	No
_____	_____	I am currently enrolled at Lane in an Associate Degree, Certificate, or other program approved for transfer to a 4-year institution.
_____	_____	I have successfully completed 12 full-time credits or 18 part-time credits.
_____	_____	I have an accumulative grade point average of 3.25 or higher.
_____	_____	Two faculty will sign to witness my self-motivation and dedication to excellence.
_____	_____	I understand that I must meet the standards outlined above and pay one-time only local, Oregon Region, and International dues.*

*Pay dues of $80 and participate in Chapter activities of my choice with no requirements to attend any activities. (Members transferring from another Phi Theta Kappa Chapter pay $30; contact the advisor for this process.)

Membership dues will only be accepted by adding CRN 11219 (summer term number) through ExpressLane. We can go online to verify that you paid.

If you answered Yes to all of the questions above, please clearly complete the following:

Name:	___________________________________________	L Number:	______________________
Address:	___________________________________________
City, Zip	___________________________________________
Phone:	___________________________________________	Graduation Term & Year:
E-mail:	___________________________________________
Major:	___________________________________________	______________________ (or transfer)

Please assist us with your membership by checking one of the following:

_____		Please call me! I would like to be involved in chapter activities.
_____		Please e-mail me about activities. I'll participate if I can.


	____________________________________		________________
	Applicant's Signature		Date

Please let us know how you learned about Phi Theta Kappa by checking the following:

_____	College Catalog		_____	The Torch		_____	PTK Members or Officers
_____	PTK Orientation		_____	PTK Advisor		Other:	______________________

I recommend this student for membership in Phi Theta Kappa.

	____________________________		__________		____________________________		__________
	Faculty signature		Lane Ext.		Faculty signature		Lane Ext.

To finish this application, complete the following FOUR steps:

_____	1.	Complete all blanks on this form.
_____	2.	Review your current transcript to make sure you meet the requirements.
_____	3.	Add the CRN and pay for Phi Theta Kappa Membership (see * above).
_____	4.	Submit all paperwork to Velda Arnaud, PTK Advisor by one of these methods:
		Mail to: Lane Community College, 4000 East 30th Avenue, Eugene, OR 97405
		Deliver to: Business Department, Building 2, Room 108D

If you have questions, call Velda Arnaud at 463-5682, or e-mail arnaudv@lanecc.edu

or

Contact the Phi Theta Kappa Office in Student Activities, Building 1, Room 206.

Phone: 463-3238; E-mail: SigmaZeta@lanecc.edu

Membership cannot be processed until you have:

_____

Completed Application

_____

Reviewed Transcript

_____

CRN & Dues

Phi Theta Kappa is very active at Lane CC and throughout the community. By completing this application, you authorize Phi Theta Kappa to use your likeness while participating in activities, without charge, for promotional purposes. These purposes may include Web site, posters, and print, audio, and video media.