*** Print this page, fill it out, and return to Sigma Tau Delta in the English Department Offices, 203 Carlisle Hall ***

Membership Application

Name:____________________________________________

Email:_____________________________________________

Student ID Number:________________________________

Current Mailing Address:_________________________________

_____________________________________________________

Permanent Mailing Address:_______________________________

______________________________________________________

Home Phone:____________________________

Work Phone:____________________________

Major/Minor____________________________

Cumulative Hours:__________________

Date of Graduation:________________

Cumulative GPA:____________

List 2 English Courses You Have Taken Above Freshman Level:

____________________________

____________________________

I give my permission for the Mu Theta Chapter to review my scholastic records to verify eligibility.

Signature:__________________________________________
Date:____________________


Return this form to the Sigma Tau Delta mailbox in the English Department Office in 203 Carlisle Hall.