Member Registration Form – Phi Sigma Iota

Online Member Registration Form

In order to serve our members, we must faithfully register our members. Chapters should maintain a local file and communicate initiation registration information promptly to the Phi Sigma Iota headquarters office. Please note the following procedures:

INITIATE REGISTRATION INFORMATION MUST BE SUBMITTED WITH PACKET ORDER AND PAYMENT. NO INITIATION MATERIALS WILL BE SENT BEFORE THIS INFORMATION IS RECEIVED. To facilitate this process, there are two ways to provide this information to the international office:

You may choose to complete the on-line registration form below for each new member. (This method is largely inefficient, unless you have only a small number of initiates.)
OR use this MS Exel file. Save it to your computer, record the information for each candidate, and attach it in an email message to the international office. Please make sure that you include all information for each initiate and that your message clearly indicates advisor name and address, chapter name, chapter number and initiation date.

Initiate Name*
First Middle Last
Permanent Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Local Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell Phone
Personal Email*
Initiation Date*
Date Format: MM slash DD slash YYYY
Chapter Member Number
Member Class*
Graduation Date*
Initiating Institution*
Chapter Number
Major*
Minor