Application Form
Instructions:
Please fill out all applicable information in the spaces below. Return the form to Dr. Terrell in Butcher Education Center 114. Dr. Terrell will verify your eligibility. You should include the $45.00 (any person not qualified to join will have their fee returned). Please make you check payable to Alpha Kappa Delta or AKD. If you have any questions or problems, please visit our website at
http://www.emporia.edu/socanth/akd/officers.htm for names of officers. Thank you for your interest in AKD!!
Today's Date _______________________________
Name (as you want it to appear on your membership certificate):
______________________________________________________________________
First, Middle, Last
Mailing Address:
Street:_____________________________________________________
City: _________________________ State : __________ Zip: ________
Local Telephone No: _______________ E-mail address: _____________________
Major(s): _________________________________ Minor: ______________________
GPA (example 3.2) Overall _______ Sociology ________
Academic Year: (circle) JR SR
Anticipated semester and year of graduation: ______________________________
Please list all Sociology courses completed:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
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