Kappa Delta Pi – Membership Application – Fall 2015

Three steps to become a KDP member:
1.  By Friday, October 2, complete the online form. Use a credit card to pay the national fee of $45. Kappa Delta Pi Headquarters requests that you pay this amount between September 17 and October 2. The amount will be charged to your card after the initiation ceremony on Sunday, November 15. https://bit.ly/kdp-C174-register
2.  By Friday, October 2, return this form and your check or money order for $25 made payable to “Kappa Delta Pi” to either:
·  San Marcos – Prof. Nathan Bond’s Office in the Education Building, Suite 3021, Room 3024
·  Round Rock – Prof. Jessica Ligon’s Mailbox # 11 (Faculty Mailroom, Avery Building, 4th Floor)
3.  Attend the initiation ceremony on Sunday, November 15 from 2 to 3:30 in the LBJ Student Center in San Marcos.

Name in the Texas State Records ______

Name as you want it to appear on your KDP certificate ______

Student ID number so that we can verify your overall GPA in Banner ______

Texas State email address ______

Local address so that we can mail your acceptance letter

Street ______

City, Zip ______

Telephone number if there are problems with your application ______

Which of the following best describes you? Undergraduate Student _____ Graduate Student _____

Which of the following best describes you? Elementary Program _____ Secondary Program _____

In which month and year will you graduate? ______

Would you like to serve as a chapter officer in?

San Marcos Yes _____ No _____

Round Rock Yes _____ No _____

How did you hear about Kappa Delta Pi? Which professor told you about KDP? ______

How many guests total, including you, will attend the initiation ceremony? ______

Do your guests need special arrangements or facilities at the ceremony? Yes _____ No _____

If yes, please describe how we can accommodate your guests. ______

/ Please note: You must attend the initiation ceremony in order to be inducted into Kappa Delta Pi. If you are unable to attend the required initiation ceremony, KDP will refund the $45 to your credit card (the national application fee) and return $5 of the $25 (the local application fee). We initiate new members during the fall and spring semesters.