PI SIGMA ALPHA

NATIONAL HONOR SOCIETY

FOR POLITICAL SCIENCE

Xi Omicron Chapter

 

APPLICATION FOR MEMBERSHIP

(Please Print)

 

 

Requirements for membership:  10 semester hours in political science completed, 3.25 G.P.A. overall, 3.4 G.P.A. in political science, and membership fees.  (You do not need to be a political science major to be a member.)

 

1.                  Date of Application:  ___________________

 

2.                  Name:  ______________________________Student ID#:  __________________

 

3.                  Major(s):  _________________________Minor(s):  _______________________

 

    __________________________                ________________________

 

4.                  Date of Expected Graduation:  _______________

 

5.                  Hours in Political Science Completed:  _________

 

6.                  G.P.A. Overall:  ____________  G.P.A. in Political Science:  ____________

 

7.                  I have enclosed a Grade Printout (  )

 

8.                  Local Address:  ____________________________________

 

  ____________________________________                                        

 

9.                  Local Phone #:  ___________________________

 

10.              E-Mail Address:  ____________________________

 

11.              I have enclosed payment of $35.00 for dues ($30 one time national association

fee; $5 annual local chapter fee).  Check ____  Cash ____ (check one).  Make

checks payable to Pi Sigma Alpha.

 

                                                           

________________________________

                                                                                   (Signed)

 

 

 

SUBMIT TO THE POLITICAL SCIENCE DEPARTMENT

STORCH MEMORIAL BUILDING RM. 105

BY MARCH 26, 2007