ZTA Alumnae information Sheet

For membership this year, a copy of this form (below) and $35 dues must be submitted to Jessie Patterson Jones. Please contact her at jlpjones2 [at] gmail [dot] com.

Thanks!

Year: 20___ to 20____

ZETA TAU ALPHA ALUMNAE INFORMATION SHEET

Name:  _____________________________________________________________________

                                First                                                                        Maiden                                                  Last

Street Address:  ______________________________________________________________

City, State, Zip:  ______________________________________________________________

Phone:  ___________________________  Email:  _______________________________

Chapter Information

Alumnae Chapter:  __________________   College Attended:  ______________________

Initiation Date:  _____________________   Current Chapter Office:  __________________

PAST HISTORY

Please list all Offices/Chair positions you have previously served. Indicate level and year if possible (ie: Alumnae, Collegiate, National):

Please list any past honors and/or distinctions you have been awarded:

¨ Certificate of Merit                                         ¨ Order of the Shield

¨ Distinguished Member                                  ¨ 25-year Member

¨ Heritage Society Member                                             ¨ Zeta Lady

¨ Honor Ring                                                       ¨ Other (please specify) ______________________

¨ Legacy

(Please continue on back)

Special Information (check all that apply)

I would be interested in serving in the following positions:

National Officer:

¨ Province President                         ¨ Zeta Tau Alpha Foundation           ¨ Mentor or Supervisor

¨ District President                            ¨ Scholarship Committee                  ¨ NPC Delegate

¨ National Housing Corporation

Standing Committees:

¨ Advisor Academy Coordinator                             ¨ Director of New Chapter                          ¨ Parents Club

¨ Alumnae/Collegiate Relations                              ¨ Fraternity Education                                 ¨ Recruitment Committee

¨ Alumnae Extension Committee                            ¨ Leadership Education &                           ¨ Ritual

¨ Alumnae Programming                                                  Development Committee                      ¨ Scholastic Achievement

¨ Archivist Chairman                                                 ¨ Music Productions                                    ¨ Standards &

¨ Chapter Financial Management                           ¨ National Anniversary                                        Enrichment

        Committee                                                            ¨ New Member Programming                 ¨ State Reference Chair   

¨Constitution & Bylaws Committee                         ¨ Nominating Committee                             ¨ Systems Development

Local Positions:

¨ General Advisor                                                      ¨ Race for the Cure Contact

¨ Financial Advisor                                                     ¨ Key Woman

¨ Membership Advisor                                             ¨ Panhellenic Advisor

¨ New Member Advisor                                            ¨ Alumnae Panhellenic Delegate

¨ PC Advisor                                                                ¨ Other (please specify)  ______________________

¨ Ritual Advisor                                                                                                                          ______________________

Special Skills:

Please list any special skill(s) you have that could benefit the Fraternity: 

____________________________________________________________________________________________________________________________________________________________________________________________________________

Signature:  __________________________       Date:  ______