Potential New Member Recommendation Form


 

Potential New Member Recommendation Form

INFORMATION ON POTENTIAL NEW MEMBER

First Name
Last Name
Middle Name
Preferred Name
Email Address
Phone Number
Name of Parent(s) or Guardian(s)
Address of Parent(s) or Guardian(s)
College or University Attending
Alpha Xi Delta Chapter
Year in College
 Freshman
 Sophomore
 Junior
 Senior
Campus Address
Name of High School Attended
Community Where High School Located
GPA
Rank in Class
Class Size
College Attended after High School, if any
GPA
Academic Honors & Accomplishments
School & Community Activities (please note any leadership positions)
Talents, Hobbies & Interests

LEGACY INFORMATION

Alpha Xi Delta Relatives (check all that apply)
 Mother/Step Mother
 Grandmother/Step Grandmother
 Sister/Step Sister
 Aunt
Name of Alpha Xi Delta Relative
Her Initiating Chapter
Address
Phone
Name of Alpha Xi Delta Relative
Her Initiating Chapter
Address
Phone
Name of Alpha Xi Delta Relative
Her Initiating Chapter
Address
Phone
Other Greek Influences

RECOMMENDATION INFORMATION

I recommend this woman
 Yes
 No
Number of years I have known this woman
Comments
Form completed by:
First Name
Middle Name
Last Name
Preferred Name
Address
Membership Status
 Alumna
 Collegian
Initiating Chapter