Delta Psi Omega Induction Report – Alpha Psi Omega National Theatre Honor Society

Name of College

Name of Chapter

College Street Address

City

State

Zip

Initiation Date*

Name of Faculty Sponsor

Email of Faculty Sponsor

There is a national initiation fee of $15 per member. Membership cards will be sent AFTER the report and dues are received and names recorded in the National Office.

1. Name of Initiates

Class

Address (home)

Fees

2. Name of Initiates

Class

Address (home)

Fees

3. Name of Initiates

Class

Address (home)

Fees

4. Name of Initiates

Class

Address (home)

Fees

5. Name of Initiates

Class

Address (home)

Fees

6. Name of Initiates

Class

Address (home)

Fees

7. Name of Initiates

Class

Address (home)

Fees

8. Name of Initiates

Class

Address (home)

Fees

9. Name of Initiates

Class

Address (home)

Fees

10. Name of Initiates

Class

Address (home)

Fees

Receipt and supplies will be sent to Faculty Sponsor unless otherwise instructed

TOTAL FEES*

Please mail your check made out to Alpha Psi Omega to David Cotter APO, PO Box 296, Camillus, NY 13031

Please Do Not Send Cash

Membership cards will be sent AFTER the report and dues are received and names recorded in the National Office.

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