ETA SIGMA PHI

Report on Initiates

Please complete this report and submit it as soon as possible after each initiation to the National Office.  The names of initiates must be typed as they should appear on the membership cards and certificates.  Click here for a pdf version of this form.

Today's Date (Enter Date in DDMMYYYY format):                       

Report of   Chapter of (Name of Institution)

Name of Adviser

Address 

Street Address City

Zip Code                                         State

Phone Number (with area code) 

E-mail Address

Date of Initiation: Month    Day   Year  
 


ACTIVE (Undergraduate) MEMBERS
  ($40.00 per initiate) 

NAMES:

1.   2.   

3.    4.    

5.    6.  

7.     8.  

9.    10.  

11.  12.   

13.  14.  

15.  16.

17. 18.  

19.    20.  

TOTAL number of Active Members:    @ $40.00 each :  Total $ 
 


ASSOCIATE (Graduate Student) MEMBERS
 ($20.00 per initiate without certificate; $30.00 with certificate)

NAMES:

1.   without certificate
2.  without certificate
3.   with certificate
4.    with certificate
TOTAL number of Associate Members without certificate:    @ $20.00: Total $

TOTAL number of Associate Members with certificate:          @ $30.00: Total $

HONORARY MEMBERS
(no fee)

Chapters are invited to nominate for honorary membership individuals who have made significant contribution to Eta Sigma Phi nationally or to the local chapter or who have been strong advocates for the study of Classics. Please provide below a supporting citation. If the nomination is approved, the national office pays for certificates for honorary members.

NAMES:

   with certificate
 Justification:      (Please add one or two sentences explaining why this individual is worthy of honorary membership. What contributions has he or she made to Eta Sigma Phi nationally or to your local chapter?)

  without certificate
 Justification:      (Please add one or two sentences explaining why this individual is worthy of honorary membership. What contributions has he or she made to Eta Sigma Phi nationally or to your local chapter?)

Replacement Certificate:
Name and Date of Initiation:  
1.   

2.   

TOTAL number of Replacement Certificates:   @ $15.00: Total $
Chapter Donation to Eta Sigma Phi Scholarship Fund:

                                              $15           $20          $25          $50            Other

                     Amount:  $    Specify specific scholarship or general fund:   

All donations will be acknowledged in the NUNTIUS.

Grand Total:  $          (Amount to be mailed to address below. Order will not be processed until fees are received.)

   

National Fees

Initiation fee for active membership, consisting of undergraduate
students duly initiated by a local chapter (including a certificate,
membership card, lapel pin and a subscription to NUNTIUS ):                                           $40 per initiate

Initiation fee for associate membership, consisting of graduate
students in Classics elected under the requirements of membership
(membership card only):                                                                                                     $20 per member

Honorary membership

 (membership card, pin and certificate)                                                                                 no charge

  Note: Local chapters are welcome to award honorary membership  to their

  chapters, but honorary membership in the national organization will be determined

  by the national office based upon the citation submitted by the local chapter.

Membership certificates for associate  members:                                                                   $10 per certificate

 Replacement certificate                                                                                                        $15.00

Please make two copies of this report. Keep one for your own records and mail the second, with a check or money order for the grand total payable to Eta Sigma Phi (please do not send the checks of individual members or cash) as soon after the initiation ceremony as possible to: 

Thomas J. Sienkewicz, Executive Secretary
Eta Sigma Phi
Department of Classics
Monmouth College
700 East Broadway
Monmouth, IL 61462
Phone:  309-457-2371
Fax:  815-346-2565
e-mail:  toms@monm.edu