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Phi Theta Kappa Membership Application

Completion of all sections of this application is a requirement of membership. Return this form to your local chapter advisor. You may find your advisor's contact information online at

* Student ID#:

* First Name:

* Middle:

* Last:

* Address:

* City:

* State:

* Zip:

* Country:

* Telephone:

* Email:

To complete your membership application, and to be considered for scholarships and other exclusive membership benefits, you must provide your graduation or transfer date and major on this form. If you do not know the exact date, use a close approximation or the date you will complete your coursework at this college.

Graduation/Transfer from the Two-Year College

* Month:

* Year:

* Academic Major Codes:

If you do not wish to receive email updates from Phi Theta Kappa, check here

If you do not wish to receive information concerning special opportunities and scholarships for members, check here

I believe in and support the purpose of the Society, meet eligibility standards for membership as stated in the Phi Theta Kappa Constitution and adhere to the moral standards of the Society. Therefore, I solemnly promise to uphold the standards of Phi Theta Kappa, and to keep this object and aim in mind, and I do solemnly pledge allegiance to my fellow members and promise to aid them in all worthy endeavors.

* Signature Required: (type full name)

* Date:

Note: To become a member, an individual must meet all membership eligibility requirements for Phi Theta Kappa according to its Constitution and Bylaw. Invitation to membership is extended by the local chapter. After becoming a member, an individual is required to maintain the minimum GPA for membership as established by the local chapter and must notify the chapter advisor immediately if at any time their cumulative GPA falls below that standard. Failure to provide notification may result in membership being automatically revoked. A member is given one term to raise their cumulative GPA to minimum standards. A person currently incarcerated is ineligible for membership. An individual convicted of a felony, or any crime whose potential sentence is greater than one year, may be considered for membership three years following completion of all conditions of sentencing, including probation.

Following the submission of your application to Phi Theta Kappa Headquarters you will receive:

An email notification within twenty-four hours that your membership has been processed. This email will contain your membership identif ication number allowing you full access to exclusive membership benef its.

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Phi Theta Kappa is committed to the elimination of discrimination based on gender, race, class, economic status, ethnic background, sexual orientation, age, physical ability, and cultural and religious backgrounds.

Student Life and Leadership at Lansing Community College

Student Life Office
Gannon Building, Room 2202
Phone: (517) 483-1285
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