Membership Verification Form
Thank you for your interest in the Bay Area Houston Alumnae chapter of Delta Sigma Theta Sorority, Inc. Please complete and submit this form to visit chapter meeting or receive information to become a member of BAHA.
Member #
*
Name
*
First Name
Last Name
Name When Initiated
*
First Name
Last Name
Chapter Where Initiated
*
Date of Initiation
*
-
Month
-
Day
Year
Date
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Last Chapter Where You Paid Grand Chapter Dues
*
Recent Graduates/Collegiates ONLY - Month/Year graduated college/university
Chapter You Wish Current Membership
*
Chapter Use Only
Please Select
CLEARED
NOT CLEARED
FOLLOW-UP NEEDED
Date Meeting Info Sent
Date Dues Info Sent
Submit
Should be Empty: