SAMPLE - CHAPTER MEMBERSHIP APPLICATION - LOCAL USE …
Sigma Tau Delta
The International English Honor Society
Zeta Tau Chapter of Liberty University
APPLICATION FOR MEMBERSHIP
Complete and return this application, along with an unofficial transcript of your grades, to Dr. Marybeth Davis, DH 2163, by Wednesday, October 13, at 4:00 p.m.
Name: ______________________________________________________________________
Last First Middle Maiden
Email: ___________________________ Student ID:_________________________________
Campus Address:_______________________________________________________________
Dorm Room University Box #
Off-Campus Address:___________________________________________________________
Street City Zip Code
Home Address:________________________________________________________________
Street City Zip Code
Local Phone: ________________________ Home Phone:____________________________
Major: ______________________________ Class Status:____________________________
Anticipated Graduation Date: ______________________ Cumulative GPA:________________
Qualifications for membership include the following:
▪ Enrollment as English major or minor (non-majors can apply for associate membership)
▪ Completion of at least the Freshman-level English requirements
▪ As or Bs earned in all English courses
▪ Overall GPA of 3.25
Admittance into Sigma Tau Delta (with remittance of induction fee) entitles you to:
▪ Lifetime membership in Sigma Tau Delta
▪ Membership certificate and lapel pin
▪ One-year semi-annual subscription to the Newsletter
▪ One-year annual subscription to The Rectangle and The Sigma Tau Delta Review
▪ Privilege of listing Sigma Tau Delta on your resumé
▪ Purchase an honor cord, honor stole, and/or medallion to wear with your graduation robe
▪ Apply for scholarship, internship, and writing award opportunities
▪ Submit papers for publication in The Rectangle and The Sigma Tau Delta Review
▪ Apply to serve on international Board of Directors as Student Advisor or Representative
▪ Submit papers or panel discussion for presentation at an annual international convention
List the grades you received or the credit you received by transfer or CLEP for the following:
English 101: _________
English 102: _________
English 200-Level (Survey): ________
Other English: ________
List all courses and grades for each completed English class for which you have credit:
ENGL ________________
ENGL ________________
ENGL ________________
ENGL ________________
ENGL ________________
ENGL ________________
ENGL ________________
ENGL ________________
All of the above information is accurate. I hereby give my permission for the sponsor of the Zeta Tau chapter to verify my GPA and my grades in English.
Signature: _________________________________________ Date: _____________________
****Include with your application a transcript that reflects all credit courses and your GPA (this can be obtained from ASIST)
****Also include a check payable to Dr. Marybeth Davis / Sigma Tau in the amount of $50.00. This amount covers both local and international dues. If your application is rejected, then your check will be returned or destroyed.
****Incomplete applications cannot be processed.
****Applications should be turned in to the English department secretary or to Dr. Davis.
******************************************************************************
SPONSOR USE ONLY: (Initial and date)
Overall GPA verified ________________ English GPA verified __________________
******************************************************************************
PAYMENT RECORD - SPONSOR/TREASURER USE ONLY: Payment received
____________________________________________________________________________________________
Amount Check Number/Cash Received by Date
Membership Profile
Name: ____________________________________________
List all campus and community activities in which you are involved. Also, include a brief description of your activities within these organizations.
Do you have a part-time job?
List any major honors you have received both at the university and high school levels.
State how Zeta Tau, your local chapter, can meet your professional development needs in the most effective way.
What skills, talents, and / or expertise do you possess that could benefit Zeta Tau?
What do you hope to gain from your membership in Sigma Tau Delta?
Do you have any interest in leadership opportunities within Sigma Tau Delta?
Name the authors / works you enjoy the most.
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