Request edit access
Theta Alpha Kappa Change of Chapter Representative Form
Please complete this form whenever your chapter has a faculty leadership transition.

Sign in to Google to save your progress. Learn more
Email *
First name of the OUTGOING chapter representative *
Last name of the OUTGOING chapter representative *
Email address of the OUTGOING chapter representative (please repeat in full, even if supplied above; do not enter "same" or similar) *
First Name (and middle initial, if desired) of the NEW chapter representative *
Last Name of the NEW chapter representative *
Postal address of the NEW chapter representative *
City *
State (two-letter postal abbreviation) *
ZIP code *
Phone number of the NEW chapter representative *
Email address of the NEW chapter representative (please repeat in full, even if supplied above; do not enter "same" or similar) *
The semester (Fall or Spring) and year when the change of leadership will become (or became) effective *
Academic Institution *
TAK Chapter Number for your chapter *
TAK Chapter Greek Letters for your chapter (spelled out, e.g., Alpha Beta Gamma)--please do not write "Theta Alpha Kappa" *
Thanks for completing this form. If you do not receive an email confirmation message shortly at the address you provided above, please contact us at theta_alpha_kappa_inquiries@ThetaAlphaKappa.org.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy