ALPHA KAPPA ALPHA SORORITY, INC.
®
5656 South Stony Island Avenue, Chicago, Illinois 60637
TRANSFER REPORT
INSTRUCTIONS:
1. THIS FORM IS TO BE USED ONLY FOR MEMBERS TRANSFERRING INTO YOUR CHAPTER WHO WERE FINANCIALLY ACTIVE LAST YEAR OR THE
CURRENT YEAR. INFORMATION FOR MEMBERS NOT FINANCIAL DURING THE PREVIOUS YEAR MUST BE SUBMITTED ON A REACTIVATION
REPORT. THE COST TO RENEW IS $110.00 FOR UNDERGRADUATES AND $135.00 FOR GRADUATES (INCLUDES PER CAPITA, EAF DUES).
2. TYPE ALL INFORMATION. ANY MISSING INFORMATION MAY CAUSE A DELAY.
3. GIVE NAME IN FULL.
4. SEND ORIGINAL WITH REMITTANCE FORM TO CORPORATE OFFICE. KEEP A COPY FOR THE CHAPTER FILE.
5. ATTACH TRANSFER VERIFICATION FORM(S).
6. LATE FINE FOR UNDERGRADUATE MEMBERS IS $9.50 AND GRADUATE MEMBERS IS $12.50
7. IF MEMBER IS ACTIVE FOR THE CURRENT YEAR, NO ADDITIONAL PER CAPITA IS TO BE REMITTED-ONLY THIS FORM.
TRANSFER VERIFICATION FORMS MUST ACCOMPANY THIS REPORT
Full Name _________________________________ Financial Number__________________
Address___________________________________ City/State/Zip_________________________
Last Active Chapter__________________________ Member Paid Previous Chapter? Yes No
Per Capita Tax and EAF Dues ________ (If After February 1, add late fine)
Full Name _________________________________ Financial Number__________________
Address___________________________________ City/State/Zip_________________________
Last Active Chapter__________________________ Member Paid Previous Chapter? Yes No
Per Capita Tax and EAF Dues ________ (If After February 1, add late fine)
Full Name _________________________________ Financial Number__________________
Address___________________________________ City/State/Zip_________________________
Last Active Chapter__________________________ Member Paid Previous Chapter? Yes No
Per Capita Tax and EAF Dues ________ (If After February 1, add late fine)
Full Name _________________________________ Financial Number__________________
Address___________________________________ City/State/Zip_________________________
Last Active Chapter__________________________ Member Paid Previous Chapter? Yes No
Per Capita Tax and EAF Dues ________ (If After February 1, add late fine)
Full Name _________________________________ Financial Number__________________
Address___________________________________ City/State/Zip_________________________
Last Active Chapter__________________________ Member Paid Previous Chapter? Yes No
Per Capita Tax and EAF Dues ________ (If After February 1, add late fine)
Total Amount Remitted on Report _$________
Chapter___________________________________ Region ______________________________
Report Sent By______________________________ Position/Office_______________________
Address___________________________________ City/State/Zip_________________________
Daytime Telephone (______)__________________ Email _______________________________
Signature__________________________________ Date____________
