Delta Sigma Theta Sorority, Inc. Membership Verification Form

Membership Verification Form
Kindly complete this form 72 hours before chapter meeting. This will ensure an accurate record of your membership. Your cooperation in this matter is greatly appeciated.
Name*

First NameLast Name
Email*
example@example.com
Full Name at Time of Initiation*

First NameLast Name
Date of Initiation

MonthDayYear
Membership Number*
Last Active Chapter*
Last Chapter in which you paid Grand Chapter Dues
Full Name When Last Active if Different from Current

First NameLast Name
Should be Empty: