Phi Theta Kappa - Beta Epsilon Theta: Induction Response Form

FQK Induction Response Form

All fields are required!

Student ID# (i.e. LUABUR1234):

Membership Type:

Regular

Active (will participate in activities when able to)

Are you willing to chair an activity?

	Yes
	No

On which committee would you like to serve? (you may choose more than one).

	Scholarship (click to learn more about scholarship)
	Service (click to learn more about service)
	Leadership (click to learn more about leadership)
	Fellowship (click to learn more about fellowship)
	None (you can still participate should you change your mind)

Would you be willing to travel to various meetings either locally or nationally?

	Yes
	No

If so, which conventions might you be interested in? (you do not have to attend, we are just checking to see who may be interested)

	Regional Conference (March)
	International Convention (April)
	International Honors Institute (June)
	Regional Summer Planning (July)
	Regional Leadership (September)
	Regional Honors Institute (November)

When will you be able to attend member meetings?

	Official Meeting (1st Saturday of each month 10am-11am)
	Day (2nd and 4th Thursday of the term from 10:15 AM - 10:45 AM)
	Night (2nd and 4th Thursday of the term from 5:30 PM - 6:00 PM)
	None, I cannot attend any meetings.

If you selected none what is the main reason you would not be able to attend?

If you are interested in an Officer position can you attend the following meetings?

	Official Meeting (1st Saturday of each month 9am-10am)
	Day (1st and 3rd Thursday of the term from 10:15 AM - 10:45 AM)
	Night (1st and 3rd Tuesday of the term from 5:30 PM - 6:00 PM)
	Executive Officer Meeting Combined (2nd to last Friday of the Month at 7:00 PM outside of school)
	None, I cannot attend any meetings

If you selected none what is the main reason you would not be able to attend?

If the chapter provides food and drinks at a meeting would you be willing to pay $3.00 to cover costs?

	Yes
	No

Which induction will you be attending?

	May (usually on a Thursday at 7:00 pm, you are excused from evening classes)
	November (usually on a Thursday at 7:00 pm, you are excused from evening classes)
	None (select none if you are not able to attend either Induction Ceremony)

If you selected none what is the main reason you would not be able to attend?

If you are attending please indicate how many guests you will be bringing?

You receive 2 tickets for free, each additional ticket will cost $2.00. You are permitted six guests maximum.


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