Please print and fill out the form below. Be sure to include:

• An initiation fee of $37 (U.S.); make checks to Dr. Michael Borgstrom (Faculty Advisor)
• A transcript showing a cumulative grade point average of 3.3 or higher

--------------------------------------------------------------------------------------------------------

Chapter Information:

Alpha Theta Epsilon Chapter
San Diego State University
5500 Campanile Dr
San Diego, CA 92182-8140

Sponsor: Dr. Michael Borgstrom
Phone: (619) 594-6284
e-mail: mborgstr@mail.sdsu.edu

Reporting Officer: Melissa Soltman

Personal information:

Name
Social Security
Permanent address
Phone
E-mail
Graduation date
Class Rank