National Reinstatement of Membership Application
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Note: This form is for inducted members of SISTUHS, Incorporated who would like to reactivate membership status, rights, and responsibilities within the organization.
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PERSONAL INFORMATION
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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CHAPTER INFORMATION
Into which chapter were you inducted into SISTUHS, Incorporated
*
What year were you inducted into SISTUHS, Incorporated?
*
Select your membership type of interest.
*
Chapter Affiliation
At-Large Affiliation
New Charter
If you selected “Chapter Affiliation” above, state your desired chapter for membership reactivation.
*
When do you plan to start your membership in your new Chapter ?
*
-
Month
-
Day
Year
Date
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REFERENCE
Please provide contact information for one (1) active member of SISTUHS, Inc. to be used as a reference.
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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DOCUMENTATION
Submit proof of FIFTEEN(15) community service documentation. Any proof of service provided will be counted towards official reinstatement, as outlined in Article XII Section 6 of the 2023-2025 National Constitution of SISTUHS, Incorporated.
*
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Submit Chapter Release Letter from Current Chapter President. *ONLY for Members who have been Inactive for UNDER TWO(2) Years. SKIP if Non-applicable*
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OPTIONAL: If possible, please provide a copy of your membership card or certificate. These documents will allow for faster verification and application processing.
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Through the submission of this form, I acknowledge and agree to abide by the bylaws of the Chapter into which I am reactivating (if applicable), as well as the National Constitution of SISTUHS, Incorporated.
NATIONAL REINSTATEMENT FEE
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National Reinstatement Fee
$
75.00
Payment Methods
Debit or Credit Card
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Last Name
Credit Card Number
Card Expiration
Security Code
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