DELTA THETA CHI SORORITY

2014 REMITTANCE FORM

Submit to:The National Office12 Pepper Tree LaneTopeka, KS 66611-2056

NAME OF CHAPTER/PROVINCE: DATE OF ORDER:

SEND ORDER TO:TITLE:

ADDRESS:

NEW MEMBER CONTRACT REMITTANCE

A Pledging Ceremony will take place on ______for the following New Members:

Name:Contract FeePro-rated DuesTotal

$25.00 In Full$3.00 / month

______

______

______

______

Totals: ______

PLEDGE PIN ORDER: Number of Pledge Pins ______@ $12.50 each = ______(add to above total) ______

Note: As of June 2004, Pledge Pins are no longer loaned. Purchased Pledge Pins may be returned to the National Office for a full refund.

Note: Pro-rated dues start the month in which the Contract is signed through December. If signed in January, full $35; signed in February through December, $3 per month.

Note: Chapter checks or money orders must accompany all orders for new contracts and national dues.

CHECK NO: TOTAL PAGE 1: TOTAL PAGE 2: AMT. ENCLOSED:

INITIATION BADGE ORDER

The following Pledges will be initiated on ______(date)

Reg. Badge Big Sis Badge Big Sister Charm*

INITIATE:Big Sister$33.00$78.00Free w/ B.S. BadgeTotal

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MAILING ENVELOPE AND POSTAGE------$3.00

Totals:

Note: If the Big Sister is ordering a Big Sister Badge and handing her Regulation Badge to her Little Sister, fill in only the amount of the Big Sister Badge and mark the gold or silver preference for the Big Sister Charm. The Little Sister pays $33.00 for her Regulation Badge whether it comes from the National Office or she receives the badge previously worn by her Big Sister. The $78.00 remittance for a Big Sister Badge ($33.00 from the Little Sister and $45.00 from the Big Sister) is collected by the Chapter Treasurer who then writes a chapter check in the amount of $78.00. *Big Sister Charms not purchased with Big Sister Badges must be paid. See page 2 for prices.

TO ORDER OTHER INSIGNIA OR SUPPLIES, COMPLETE ORDER FORM ON PAGE 2.

Last Revised: 5/7/2015

Effective July 2014DELTA THETA CHI SORORITY

2014REMITTANCE FORMPage 2

INSIGNIA:

Recognition Pin (Chapter)GK$10.0010KN/AQty()$

Pledge Pin (Chapter)GK$12.5010KN/AQty()$

Regulation BadgeGK$33.0010KN/AQty()$

Big Sister BadgeGK$78.0010KN/AQty()$

Special Recognition BadgeGKN/A10K $120.00Qty()$

Miniature Pledge Pin (for daughters)GK$10.0010KN/AQty()$

Auxiliary Lapel Pin for MenGK$12.0010KN/AQty()$

Emerald Crest Charm (Province President)GKN/A10K$50.00Qty()$

DANGLES / CHARMS:( ) 25-Year( ) 50-Year ( ) 60-Year$20.00eachGUARDS:$22.00 each Qty ( ) $

President’s Gavel Guard ( ) Charm ( )GK$16.50( )Plain10K$24.00( ) PearlQty( ) $

Big Sister Charm - Gold ( ) Silver ( )GK$16.00( ) GoldGK$15.00( ) SilverQty()$

*Officer Guard - order of one (1) onlyGK$15.00( )10K$24.00( )Qty()$

*Officer Guard - order of two (2) or moreGK$14.00( ) each10K$23.00( )eachQty()$

*Officer Charm - order of one (1) onlyGK$11.00( )10K$20.50( )Qty() $

*Officer Charm - order of two (2) or moreGK$10.00( ) each10K$18.50( ) eachQty()$

*Sponsor Charm - order of one (1) onlyGK$15.50( )10K$20.50( )Qty()$

*Sponsor Charm - order of two (2) or moreGK$11.00( ) each10K$16.00( )eachQty()$

Greek Letter Chapter Guard - order of one (1) onlyGK$15.00( ) Plain10K$49.00#( )PearlsQty( ) $

Greek Letter Chapter Guard - order of two (2) or moreGK$13.00( ) each 10K$49.00#( )eachQty( ) $

*Charter Chapter Member Rose Guard ( ) Charm ( ) GK$18.00( )10KN/AQty() $

*Filligre Crest Charm (Past President’s Award)$67.00Qty()$

SUPPLIES:Sheet Music$3.00()Book of Rituals $10.00()DTC Manual$5.00( ) Pledge Manual $10.00 ( ) $

Informal Crest Notes:10 - $7.50()15 - $11.00()20 - $14.50()25 - $17.00( ) 50 - $30.00 ( ) $

MAILING ENVELOPE AND POSTAGE$3.00

* Special Order Items. Allow 6-8 weeks deliveryPAGE 2 TOTAL$

Last Revised: 5/7/2015