Initiate Submission Form Please complete the following information for new initiates. When you are finished, you can submit this form by e-mail or print it and send it with a check made payable to “Phi Alpha Theta.” If you would like to process the initiate fees online, use the following link: https://secure.touchnet.com/C20235_ustores/web/product_detail.jsp?PRODUCTID=2369&SINGLESTORE=true

School Name:

Initiation Date (if it varies by member, please indicate dates and applicable names in the "Notes" area at the end):

First Name Middle Name Last Name e-mail Address (not a school e-mail) Address

Country

Total Fees:

Notes

https://secure.touchnet.com/C20235_ustores/web/product_detail.jsp?PRODUCTID=2369&SINGLESTORE=true

Tunstall, Graydon

9.0.0.2.20120627.2.874785

Initiate Submission Form

Please complete the following information for new initiates. When you are finished, you can submit this form by e-mail or print it and send it with a check made payable to “Phi Alpha Theta.” If you would like to process the initiate fees online, use the following link:      

                        https://secure.touchnet.com/C20235_ustores/web/product_detail.jsp?PRODUCTID=2369&SINGLESTORE=true

First Name

Middle Name

Last Name

e-mail Address

(not a school e-mail)

Address

ChapterName: InitiationDate: PrintButton: ResetButton: FName: first nameMN: middle nameLN: last nameEmail: e-mail addressAddress: street addressState: stateCountry: USAZipCode: zip codeCity: cityAddItem: DeleteItem: TotalFees: TextField1: