First Name:

Middle Name:

Last Name:

School Address:

Apartment #:

State:

Zip Code:

Phone Number:

E-Mail:

Confirm E-Mail:

Name and address of parents or nearest relative:

Gender:Male Female

Marital Status:Not Married Married

Citizenship:U.S. Citizen Non U.S. Citizen

Birth Date: mm/dd/yy

Year: Freshman Sophomore Junior Senior

Major(s):

Minor(s):

Are you a member of (check any that apply): Alpha Kappa Psi Phi Chi Theta Phi Gamma Nu

Names & Chapter of any relatives belonging to Delta Sigma Pi:

Number of credit hours completed (total @ WMU):

Cumulative GPA:  

How did you learn about this recruiting function?

Why would you like to join Delta Sigma Pi?

What characteristics do you have to offer Delta Sigma Pi?

What other campus organizations are you affiliated with?

What are your hobbies?

What characteristics do you feel make up a good leader? Do you feel you possess these?

What would previous employers most likely say about you?

Are you available from 5pm-7pm on Sundays for pledge meetings?
Yes No

Are you available from 7pm-9pm on Sundays for general business meetings?Yes No

Please ensure all information is correct before submitting.