Mortar Board Gift Membership Petition
Each chapter is allowed one gift membership each year, which waives the national membership dues for one student. Chapters may opt to use the gift membership fully on one student ($100) or split the gift membership between two students ($50) to reduce their payment. If splitting the gift membership, please submit this form twice. THIS FORM IS FOR CHAPTER USE ONLY.
Chapter & Contact Information
Institution (college or university)
*
Chapter name
Name of person submitting this form
*
First Name
Last Name
Email of person submitting this form
*
example@example.com
Phone Number of person submitting this form
*
-
Area Code
Phone Number
Gift Membership Information
Name of student receiving gift membership
*
First Name
Last Name
Email of student receiving gift membership
*
example@example.com
Amount of gift membership
*
Full gift membership ($100)
Half gift membership ($50)
Gift memberships are for national dues. Those chapters who charge local dues are given the option to waive the new member's local dues as well. Do you want to waive the local dues for this student?
*
Waive the local dues
Charge the local dues
Not applicable - we don't collect local dues
Submit
Should be Empty: