Recommendation Form for a Potential Member

Kappa Alpha Order

Potential member is attending (college/university)
Recommendation submitted to chapter of Kappa Alpha Order
 
Potential Member's Information
Potential Member's Name
Potential Member's Phone Number (h)
Potential Member's Phone Number (c)
Potential Member's Email Address
Campus Address (if known to be accurate)
 
City State
Zip
What KA relatives or close friends does he have?
Parent(s) Name
Parent(s)/Home Address
 
City State
Zip
Parent(s)/Home Phone Number
High School
Year Graduated
High School Academic Honors, Standing, GPA, etc.
Community, Church, Extracurricular, and/or Athletic Activities/Involvement, etc.
Current College/University Academic Standing and/or GPA, etc. (if applicable)
Current or Potential Higher Education Course of Study
Further Comments
 
Recommendation Submitted by
Name
Mailing Address
 
City State
Zip
Phone Number
Email Address
Initiation Chapter and Year
Relation to Potential Member
We appreciate you taking the time to complete this form. You may be assured that we will give the young man every consideration during Rush.
   
 

 

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