RECEIPT OF MONEY FORM

DELTA SIGMA THETA SORORITY, INC.

SUBURBAN HOUSTON-FORT BEND ALUMNAE CHAPTER
RECEIPT OF MONEY FORM
Note to Payer: If you are not sure of the amount you should pay, please
contact the Financial Secretary prior to submittal - financialsec@shfbac.org
PAYER'S INFORMATION
Check/Money Order/CashPayPal
MEMBERSHIP NUMBER*
YOUR NAME (if paying for someone else, please place their name here)*

First NameLast Name
Payer's Email *
example@example.com
PHONE NUMBER*

Area CodePhone Number
PAYPAL ACCOUNT OWNER (if different than your personal name)
ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code
Reclaimed SororTransitioned Soror
If you are a Reclaimed or Transitioned Soror, Please type the name of the Soror who assisted you:
PAYPAL - DUES, PRODUCTS AND SERVICES
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2026 Sorority Year Dues - Diamond & Golden Life Member$181.84
Includes Local Dues, National Per Capita and PayPal Fee

2026 Sorority Year Dues - Regular Member Reinstatement - Unfinancial LESS THAN 2 years$394.25
Includes Local Dues, National Dues, National Per Capital, National Reinstatement fee and PayPal fee.

2026 Sorority Year Dues - Regular Member Reinstatement - Unfinancial MORE THAN 2 years $409.79
Includes Local Dues, National Dues, National Per Capital, National Reinstatement fee and PayPal fee.

2026 Local Dues Only (Transfer Sorors Only)$171.47
Includes Local Dues and PayPal Fee

2026 Sorority Year Dues - Member-at-Large Reinstatement - Unfinancial LESS THAN 2 years $420.15
Includes Local Dues, National Dues, National Per Capita, Reinstatement fee, Transition fee and PayPal fee.

2026 Sorority Year Dues - Member-At-Large Transition into Chapter - Currently Financial$197.38
Includes Local Dues, National MAL Transfer fee and PayPal fee

2026 Sorority Year Dues - Member-at-Large Reinstatement (UNFINANCIAL for MORE than two (2) years$435.70
Includes Local Dues, National Dues, National Per Capita, National Reinstatement Fee, National Transition Fee and PayPal fee.

May Week Luncheon$44.03
Includes May Week Luncheon Ticket and PayPal Fee.

Vegan MealGluten Free Meal

The 50th Chapter Anniversary Celebration$135.21
Includes Ticket Price and PayPal Fee

Vegan MealGluten Free Meal

Past Presidents' Scholarship Contribution$339.33
Includes PayPal fee

Total $0.00
DUES, PRODUCTS AND SERVICES
50th Chapter Anniversary Celebration- $130.00Past Presidents' Scholarship Contribution-Enter Desired Amount2026 SORORITY YEAR (JAN 2026 - DEC 2026) -DIAMOND/GOLDEN LIFE MEMBER - $175.002026 SORORITY YEAR (JAN 2026 - DEC 2026) -REGULAR MEMBER REINSTATEMENT- Unfinancial for LESS THAN 2 years - $380.002026 SORORITY YEAR (JAN 2026 - DEC 2026) - REGULAR MEMBER REINSTATEMENT - Unfinancial for MORE THAN 2 years - $395.0050th Giving Campaign- Enter Desired Amount2026 SORORITY YEAR (JAN 2026- DEC 2026)- MEMBER-AT-LARGE Reinstatement- Unfinancial for MORE THAN 2 years- $420.002026 Local Dues Only (Transfer Sorors Only)- $165.002026 Sorority Year Dues - Member-At-Large Transition into Chapter - Currently Financial- $190.00
Vegan Meal
Gluten-Free Meal
TOTAL DUES, PRODUCTS & SERVICES
GENERAL SCHOLARSHIP DONATION
SCHOLARSHIP CONTRIBUTION (Enter Amount)
TOTAL DONATION
TOTAL DUES, PRODUCTS & SERVICES, DONATION
CHECK/MONEY ORDERCASH
CHECK/MONEY ORDER AMOUNT
PAYABLE TO: Delta Sigma Theta Sorority, Inc.
CHECK/MONEY ORDER NUMBER*
CASH AMOUNT
TOTAL FUNDS RECEIVED
COMMENTS
Mail payment to:
Delta Sigma Theta Sorority, Inc.
Attention: Financial Secretary
P. O. Box 2066
Missouri City, TX 77459
Should be Empty:

DELTA SIGMA THETA SORORITY, INC.

PAYER'S INFORMATION

DUES, PRODUCTS AND SERVICES

GENERAL SCHOLARSHIP DONATION