Delta Sigma Theta Sorority, Inc | SAAC Member Verification Form

SAAC Member Verification Form

Please complete this form at least 3 days prior to attending a chapter meeting. Once your membership is verified, we will contact you. This form is ONLY for members of Delta Sigma Theta and NOT for persons interested in membership.

What is your reason for filling out this form? (Select One)

Name

First

Last

Maiden Name

First

Last

Street Address

Address Line 2

City

State

Zip Code

Phone

Full Name at time of initiation

Date of Initiation* (Approximate month/year)

Membership Number

Last chapter in which you paid Grand Chapter Dues

Full name at last time you paid Grand Chapter Dues

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