Check
One
I.
II.
$750.00
$550.00
III.
IV.
10 Years Financially Active
10 Years Financially Active (2011-2020)
50 Years Financially Active
Partial Payment or Deposit
$100.00
$100.00
Check
Amount
$
Check #
Please expect confirmation of your Life Membership in 6 to 8 weeks. If application is in order, you will be mailed
a Life Membership certificate, pin, and card to the address on the application.
ALPHA
KAPPA
ALPHA SORORITY, INCORPORATED®
5656 S
outh Stony Island
Chicago, Illinois 60637
Life Membership Application
You must be financially active at the time that you are applying for Life Membership
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Date _________________ Current Chapter _________________________
Full Name _________________________________ Other Names______________________________
Address___________________________________ City/State/Zip_____________________________
Initiation Chapter____________________________ Location __________________________ Initiation Year ________________
Email Address______________________________ Daytime Telephone (______)__________________ Date of Birth________________
We WILL NOT mail to PO Boxes, please provide a physical shipping address to receive the Life Member award.
Give all previous last names you have used (for purposes of checking records):
_______________________________________________________________________________________________________
Give names and addresses (if possible) of at least two (2) sorors who were present at your
initi
ation.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
General Members
, this form must be sent to the Alpha Kappa Alpha Corporate Office for appropriate signatures
Graduate Chapter Members
must obtain signatures of the Basileus and Grammateus on the second page of this form.
Submission without the signatures WILL cause a delay in processing.
This form is to be accompanied by $750.00, $550.00 or $100.00 in the form of a chapter check, certified cashier's check, or
money order. Make check payable to Alpha Kappa Alpha Sorority, Inc. Further Life Membership information can be found in
the Constitution and Bylaws, Article IV, Section 9.
Send a deposit of $100 to research your eligibility. All money sent
for Life Membership goes toward the total payment. The corporate
office will respond with which rate you are eligible to pay.
If you do not qualify for Life Membership, your check will be returned
to you.
________________________
_____________________
Financial Card Number______________________
I.
$750.00
Life
Membership
(Any 10
Financial Years
Prior to Application)
Chapter Name
Year(s)
Chapter Name
Year(s)
II. $550.00
Life
Membership
(2011 - 2020 Financially Active)
Chapter Name Year(s) Chapter Name
Year(s)
III.
$100.00
Life
Membership
(50
Years Financial with
the Sorority)
Chapter Name Year(s) Chapter Name
Year(s)
Your
Signature
Chapter Basileus'
Signature
Phone
No.
Chapter
Grammateus' Signature
Phone
No.
Executive Director (For General Members Only)
To assist us in expediting your Life Membership Application, please list all previous chapters
with appropriate signatures.
_____________________________________________________
_______________
_______________
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit