Membership Registration 2021

The Chapter Member Registration is completed bi-annually to the National Office. The information collected on the form is the Officers, Advisor, New Members and Active Members contact information. Active members are reported each fall and spring semesters and new members are reported prior to their initiation to the Chapter. Membership dues ($25) and New Member initiation fee ($35) should be collected by the Chapter Treasurer each semester. There will be a $25 late fee added to forms submitted after March 31 and October 31.

Chapter Information

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Chapter Members

Active members are students initiated by an undergraduate chapter, who are pursuing regular courses in the college or university. Active member dues are $25 per semester and do not exceed $50 per school year.

Member Information
Member {binding ItemNumber}
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Officer? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
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Faculty Advisor {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Shipping & Handling

Membership supplies will only be shipped to the office of the Faculty Advisor, marked with attention to the Chapter President. We will not ship to a personal address.

Membership Materials

Chapter Representative {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Faculty Advisor Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Payment by Check {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Payment by Credit Card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please mail check to:

Virginia Spikes
887 Waif Woods Lane
Cordova, TN  38018

Verification {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

Membership Registration 2021

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

Membership Registration 2021

The Chapter Member Registration is completed bi-annually to the National Office. The information collected on the form is the Officers, Advisor, New Members and Active Members contact information. Active members are reported each fall and spring semesters and new members are reported prior to their initiation to the Chapter. Membership dues ($25) and New Member initiation fee ($35) should be collected by the Chapter Treasurer each semester. There will be a $25 late fee added to forms submitted after March 31 and October 31.

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

Chapter Information

School/University {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Semester {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Chapter Members

Member Information
Member {binding ItemNumber}
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Membership Status {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Graduation Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Officer? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Officer Position {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }
Faculty Advisor {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Facebook {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Instagram {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
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Shipping & Handling

Membership Materials

Chapter Representative {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Initiation Date for Current Semester {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
School/University {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Faculty Advisor Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Payment by Check {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Payment by Credit Card {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Please mail check to:

Virginia Spikes
887 Waif Woods Lane
Cordova, TN  38018

Verification {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Cognito Forms{{ Cognito.resources["powered-by-cognito"] }}