2020
GRADUATING PHI THETA KAPPA MEMBERS
Please fill out this form to have your name displayed in this year’s Graduation Program
under “Phi Theta Kappa”.
To order your graduation regalia from Phi Theta Kappa online: http://www.ptk.org.
Make sure to have your membership number ready for ordering. If you do not know your
ID number, visit our chapter’s website at www.ptk.org for instructions.
Please note: Provisional Members are not recognized by Phi Theta Kappa International,
and, therefore, are not authorized to wear any Phi Theta Kappa graduation regalia.
However, Provisional Members will have their name displayed on the graduation
program, and are allowed to walk with other Phi Theta Kappa members during
graduation.
NAME (PRINT): ________________________________
CSID#: _________________
Check one:
Full Member
Provisional Member
PLEASE RETURN TO STUDENT AFFAIRS, ROOM M-200 BY APRIL 13, 2020.