National Staff Application - Kappa Alpha Order

Name

This field is for validation purposes and should be left unchanged.

Contact Information

Full Name*

Name*

First Middle Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email Address*

Home Phone*

Cell Phone*

Date available to work*

For which position are you applying?*

Academic Record

1) College/University Attended*

Degree Attained*

Major(s) and Minor(s)*

Dates of Attendance*

GPA*

2) College/University Attended

Degree Attained

Major(s) and Minor(s)

Dates of Attendance

GPA

3) College/University Attended

Degree Attained

Major(s) and Minor(s)

Dates of Attendance

GPA

Fraternity Record

Initiation Chapter*

Initiation Year*

Other chapter affiliation (when/where)

Offices Held & Year

National Programs Attended and Year

Extracurricular Activities & Interests

On campus honors, awards, clubs.

Community organizations or involvement.

Hobbies or special interests.

General Questions

Notice Regarding Sealed Criminal Records: Under Virginia law, applicants are not required to disclose information about any arrest, charge, or conviction that has been sealed. If you have a sealed record, you do not need to reference it when answering questions on this application.

Are you willing to relocate to Lexington, VA?*

Yes

Ever been convicted of driving while impaired?*

Yes

If so, please explain with date and location.

Received a moving violation in past 5 years?*

Yes

If so, please list with date and location.

Do you have any visible tattoos or piercings?*

Yes

You may attach a resume.

Max. file size: 50 MB.

You may attach a cover letter or personal statement.

Max. file size: 50 MB.

Send a copy of my application to me upon submission?

Yes

Email to send copy to