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Delta Chapter –
Classroom Building 315
Alpha Beta Gamma
International
Business Society
National Office
75 Grasslands
Road
Valhalla, NY
10595
Last Name: ____________________ First Name:
____________________ Initial: _____
Phonetic Pronunciation of Last Name (if appropriate):
________________________________________
Please print name
exactly as you wish it to appear on your membership certificate:
____________________________________________________________________________________
Street: ______________________________________________
City: ____________________________ State: __________
Zip: ______________
Telephone: ( ) __________________ Social Security #:
_______-_____-_______
( ) Full-time Student Email
Address: _____________________________
( ) Part-time Student
Cumulative G.P.A: __________ Total Credits
Earned-to-Date: ____________
Major: _______________________ Expected Graduation Date:
_____________________
Do you expect to transfer to a 4-year college? ________
If so, please list
your 3 top choices:
________________________________________________________,
__________________________________________, and
_______________________________________.
Club Activity at
College:
_________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Are you currently employed? __________ Name of Employer:
_________________________________
Please describe any
community service that you perform:
_______________________________________
______________________________________________________________________________________
I certify that the above information is correct. I accept the
invitation to join the Delta Chapter of Alpha Beta Gamma
International Business Honor Society. I will make every effort
to attend the Initiation Ceremony.
Signature:
________________________________________________
Date: ________________
Faculty Advisor Approval: ___________________________________
Lifetime
Membership is $55.00. Please make checks payable to FSA / Alpha
Beta Gamma.
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