Traveling Educational Consultant Application

Traveling Educational Consultant Application

INSTRUCTIONS: PLEASE COMPLETE THIS APPLICATION AND SEND IT, WITH NECESSARY ATTACHMENTS, TO THETA PHI ALPHA NATIONAL OFFICE, 27025 KNICKERBOCKER ROAD, BAY VILLAGE, OHIO 44140-2300. THE COMPLETED APPLICATION, WITH ATTACHMENTS, AND THE LETTERS OF REFERENCE MUST BE RECEIVED NO LATER THAN MARCH 1 FOR THE JUNE START DATE AND NO LATER THAN OCTOBER 6 FOR THE JANUARY START DATE.

IF ADDITIONAL SPACE IS NEEDED TO RESPOND TO A QUESTION, PLEASE ATTACH PAGES AS NECESSARY.

GENERAL INFORMATIONPLEASE CIRCLE DESIRED START DATE: JANUARY JUNE 20

NAME:

(FIRST)(MIDDLE)(LAST)

SOCIAL SECURITY NUMBER:

DRIVERS' LICENSE NUMBER: STATE:

CHAPTER OF INITIATION: COLLEGE/UNIVERSITY:

HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO

PLEASE LIST ANY RESTRICTIONS REGARDING TRAVEL.

ARE YOU ACQUAINTED WITH, OR RELATED TO, ANY THETA PHI ALPHA EMPLOYEES OR NATIONAL OFFICERS? YES NO IF YES, PLEASE IDENTIFY.

IN THIS SECTION, PLEASE PROVIDE INFORMATION ABOUT YOUR PERMANENT ADDRESS:

HOME ADDRESS:

(CITY)(COUNTY)(STATE)(ZIP CODE)

HOME PHONE NUMBER: ( )

IN THIS SECTION, PLEASE PROVIDE INFORMATION ON WHERE YOU CAN BE REACHED DURING THE SCHOOL TERM:

SCHOOL ADDRESS:

(CITY)(STATE)(ZIP CODE)

SCHOOL PHONE NUMBER: ( )

IN CASE OF EMERGENCY, PLEASE NOTIFY:

NAME:

ADDRESS:

(CITY)(STATE)(ZIP CODE)

PHONE NUMBER: ( )

EDUCATION

HIGH SCHOOL ATTENDED:

(NAME)(CITY)(STATE)

COLLEGES/UNIVERSITIES ATTENDED FOR UNDERGRADUATE DEGREE:

(NAME)(CITY)(STATE)(DATES ATTENDED)

GRADUATION DATE: CUMULATIVE GPA:

DEGREE:

MAJOR: MINOR:

PROVIDE THE NAME AND LOCATION OF OTHER SCHOOLS ATTENDED OR MILITARY SERVICE, INCLUDING CERTIFICATES OBTAINED AND OTHER PERTINENT DATA.

DESCRIBE YOUR EXPERIENCE USING COMPUTERS, INCLUDING SOFTWARE PACKAGES USED.

HAVE YOU COMPLETED ANY GRADUATE WORK? YES NO

IF YES, PLEASE EXPLAIN.

ACADEMIC SCHOLARSHIPS OR HONORS:

EXTRACURRICULAR ACTIVITIES:

COMMUNITY INVOLVEMENT:

TRADE OR PROFESSIONAL ORGANIZATIONS:

SPECIAL INTERESTS/HOBBIES:

EMPLOYMENT INFORMATION

LIST YOUR CURRENT OR MOST RECENT EMPLOYER FIRST:

NAME/ADDRESS OF EMPLOYER DATE OF EMPLOYMENTPOSITION/DESCRIPTION OF DUTIES

FRATERNITY EXPERIENCE

DATE PLEDGED: DATE INITIATED:

CHAPTER OFFICES HELD:

THETA PHI ALPHA AND/OR OTHER GREEK CONFERENCES ATTENDED:

THETA PHI ALPHA ACCOMPLISHMENTS/ACHIEVEMENTS/AWARDS:

NARRATIVE

PLEASE ATTACH A BRIEF NARRATIVE EXPLAINING WHY YOU WANT TO SERVE THETA PHI ALPHA AS A TRAVELING EDUCATIONAL CONSULTANT (TEC). THE NARRATIVE SHOULD BE NO LONGER THAN 3 TYPEWRITTEN PAGES AND SHOULD INCLUDE ANY SPECIAL TALENTS YOU HAVE TO OFFER THE FRATERNITY. HOW HAS YOUR ACADEMIC OR EMPLOYMENT EXPERIENCE PREPARED YOU FOR THIS POSITION? DESCRIBE MAJOR ACCOMPLISHMENTS. WHAT DO YOU HOPE TO ACCOMPLISH WHILE TRAVELING AS A TEC? WHAT WOULD BE YOUR GOALS FOR THE YEAR?

REFERENCES

IT IS YOUR RESPONSIBILITY TO SEE THAT THETA PHI ALPHA RECEIVES YOUR REFERENCES NO LATER THAN MARCH 1 FOR THE JUNE START DATE AND NO LATER THAN OCTOBER 6 FOR THE JANUARY START DATE. PLEASE SECURE LETTERS OF REFERENCE FROM THREE (3) OF THE FOLLOWING INDIVIDUALS (NOT RELATED TO YOU): (1) BOARD OF DIRECTORS CHAIRMAN, OTHER ALUMNAE ADVISOR, OR FACULTY ADVISOR; (2) PANHELLENIC OR GREEK ADVISOR; (3) PROFESSOR IN YOUR MAJOR; (4) EMPLOYER; OR (5) CHAPTER PRESIDENT OR CONFERENCE DIRECTOR.

THE LETTERS OF REFERENCE SHOULD BE SENT DIRECTLY TO NATIONAL OFFICE BY THE INDIVIDUAL. LETTERS OF REFERENCE SHOULD NOT BE ATTACHED TO THIS APPLICATION.

THETA PHI ALPHA FRATERNITY

POLICY ON DISCRIMINATION

Theta Phi Alpha Fraternity believes it is inherent in our principles that no one be discriminated against on the basis of race, national origin, age, religion, marital status, or physical or mental capacity disability. Neither the National Fraternity, nor any chapter, colony, or alumnae association may discriminate against anyone including through its constitution, bylaws, policies, or procedures.

Please include a photo of yourself with your application.