Phi Theta Kappa Membership Application
Completion of all sections of this application is a requirement for membership. Return this form to your local chapter advisor. You many find your advisors contact information online at www.ptk.org/directories/chp_intro.htm.
Are you a new or a continuing member? *
First Name: *
Your answer
Middle Name:
Your answer
Last Name: *
Your answer
SMC Student Email: *
Your answer
Personal Email: *
Your answer
Social Media:
Your answer
Student ID# *
Your answer
Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Telephone: *
Your answer
I wish to receive email updates from Phi Theta Kappa: *
I have met all membership eligibility requirements for Phi Theta Kappa and have been extended an invitation for membership in my local chapter. I believe in and support the purpose of the Society as stated in the Phi Theta Kappa Constitution, adhere to the moral standards of the Society, and currently enjoy the full rights of citizenship, freedom, and privileges of my country (International students attending college on a United States student visa and who possess full rights of citizenship of their country are eligible for membership). I understand that there is a required GPA for maintaining membership in Phi Theta Kappa and agree to notify my chapter advisor immediately if at any time I fail to maintain my chapter’s maintenance GPA. Therefore, I solemnly promise to uphold the standards of Phi Theta Kappa, and to keep this object and aim in mind, and I do solemnly pledge allegiance to my fellow members and promise to aid them in all worthy endeavors. SIGNATURE (Type full name and date to sign electronically) : *
Your answer
Date: *
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Following the submission of your application to Phi Theta Kappa Headquarters, please see the Treasurer to pay your fees. After that, please show your receipt to the Director of Membership to activate your Canvas Account. You cannot start receiving forum and event credit until this is done.
At the end of the semester, you will receive: An email notification within twenty-four hours that your membership has been processed. This email will contain your membership identification number allowing you full access to exclusive membership benefits. A Member Benefit Packet via mail within three weeks containing your Golden Key Membership Pin and detailed information onsecuring your exclusive membership benefits. Recognition in Phi Theta Kappa’s Online Member Directory at www.ptk.org.
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