Missouri Alumni Association Membership Application
By submitting this application, you are verifying that you do now or by the end of your current semester will qualify as an alumnus member. An alumnus member shall be a former chapter member of the Phi Theta Kappa Honor Society who was duly inducted, who was enrolled for at least one year in a two-year college, and who has left active membership in good standing. Leaving active membership may be for any reason or by any method, including, but not limited to, graduation, transfer, ceasing enrollment, or ceasing active participation as a chapter member. All information provided on this form is for the sole use of the MAA and is never shared with anyone not associated with Phi Theta Kappa.
Name when inducted in Phi Theta Kappa (if different from above)
City, State, Zip Code
Non-School Email Address
Year Inducted in Phi Theta Kappa
College/Location and Chapter Name
Year Attained Alumni Status (graduated or transferred from community college)
Competitive Edge Level
MAA Committee(s) You Are Interested in Joining (Please check all that apply):
Membership Recruitment Committee
Regional Activities Committee
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