Petition for Honorary Membership

Petition for Honorary Membership

© Mortar Board, Inc.
Honorary membership, being the highest honor given by the Society, may be conferred by a collegiate chapter or the National Council only upon a person who is not a college student, who has earned a baccalaureate degree, and who has made a distinguished contribution toward the advancement of the goals and purposes of the Society. An alumni chapter may recommend a person for honorary membership, but honorary membership may be conferred only by a collegiate chapter or the National Council.

The nomination must be supported by the majority of the collegiate chapter membership. This form must be received by the National Office at least two weeks prior to tapping. Candidates cannot be tapped until approval from the National Office has been received.
I. CHAPTER INFORMATION
College/University
Chapter name
Contact name
Contact position
Contact email
Contact phone

Area CodePhone Number
If the chapter president is not completing this form, please provide their name here
Chapter president email
Chapter president phone

Area CodePhone Number
Advisor name
Advisor title
Advisor email
Advisor phone

Area CodePhone Number
Tapping date
Initiation date
Will this candidate be initiated on the same day as collegiate members?
II. HONORARY CANDIDATE CONTACT INFORMATION
Full Name

PrefixFirst NameMaiden NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
Phone Number

Area CodePhone Number
III. CANDIDATE HISTORY

A resume, CV or professional bio is requested for the review of an honorary member petition. If one is not available please fill out employment and academic history in full.
Resume or CV

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Link to bio
Is this candidate currently a Mortar Board advisor?
Current employer

Organization/Company name

Position

LocationDates

Postal / Zip Code
Previous employer

Organization/Company name

Position

LocationDates

Postal / Zip Code
Previous employer

Organization/Company name

Position

LocationDates

Postal / Zip Code
Undergraduate institution

College/University

Program (ex: Education)

Degree earned (ex: B.A.)Dates attended

Postal / Zip Code
Graduate institution

College/University

Program (ex: Psychology)

Degree earned (ex: Ph.D.)Dates attended

Postal / Zip Code
Other institution

College/University

Degree Earned

Degree earnedDates attended

Postal / Zip Code
III. EXPLANATION OF NOMINATION
Please explain why the chapter would like to make this candidate an honorary member.
How will this candidate add to Mortar Board's presence on campus?
I have verified that this candidate is not already a member of Mortar Board.
Browse Files

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