PHI ETA SIGMA
CHAPTER ORDER FORM

CHAPTER		DATE OF INDUCTION
	(School Name)

CHAPTER ADVISER’S SIGNATURE

	Student memberships with key @ $20 each
	Student memberships with tie tac @ $20 each
	Honorary memberships with key @ $20 each
	Honorary memberships with tie tac @ $20 each
	Replacement keys @ $3.50 each
	Replacement tie tacs @ $3.50 each
	Replacement certificates @ $3 each
	Banquet program covers @ $.15 each
	Honor cords (minimum order—10) @ $8 each
	Honor medallions (minimum order—10) @ $8 each
	Crests (2 ft. by 3 ft.) @ $25 each
	(to be framed for chapter activities)

AVAILABLE WITHOUT CHARGE (please indicate quantities requested):

	Phi Eta Sigma Question and Answer Brochures
	Membership Pads (100 slips per pad)
	Induction Ceremony Booklet (max. 2 copies per order)
	Chapter Adviser’s Manual (max. 2 copies per order)

Membership slips should be submitted with this form three weeks before induction to:

Phi Eta Sigma National Honor Society
1906 College Heights Blvd. #11062
Bowling Green, KY 42101-1062
(Office phone: 270-745-6540)

Make checks payable to Phi Eta Sigma National Honor Society.

Please visit our web site for additional items available to chapters and to individual members: www.phietasigma.org