To be submitted to 
national office early
each fall semester
PHI ETA SIGMA
DIRECTORY AND ACTIVITIES REPORT
AND
ORDER FORM FOR FORUM MAGAZINE
 
 
 

*Indicates required field
 

*Please use this form to submit chapter news and contact information, as well as to order a supply of Forum magazines, only if you do not plan to mail in the pink Directory/Activities sheet mailed to chapter advisers each August.  Please do not send in this information to the national office by both methods.  Thank you.
 

Chapter*
 
 
Chapter Code*: 
Chapter Adviser's Name* (include Dr., Mr., Ms., etc):
Adviser's E-mail*: 
Adviser's Phone No.: 
Adviser's Campus Address:

City  State   Zip Code 

Chapter Officers:
 
Chapter President:
Vice President:
Secretary:
Treasurer:
Historian/Correspondent:
Senior/Junior Adviser:

Please describe in the space below the activities and projects of your local chapter.  (Or you may provide a more detailed report by e-mail.)  Include any meetings, awards, tutoring services, assistance at school functions, congratulatory letters, sponsored lectures or programs, social events, etc., you provide or take part in.  (Information reported to the national office by October 1 will be included in the next FORUM issue.)


Enter here the number of FORUM magazines you will need for delivery in January:
(Quantity should approximate number of new members inducted in current academic year.)
 
 
 

Date
Reporting Officer