New Member Recommendation



INFORMATION ON POTENTIAL NEW MEMBER
First Name : 
Last Name : 
Middle Name : 
Preferred Name : 
Name of Parent(s) or Guardian(s) : 
Address of Parent(s) or Guardian(s) : 
College or University Attending : 
Alpha Xi Delta Chapter : 
Year in College : 
 Freshman
 Sophomore
 Junior
 Senior
Campus Address : 
Name of High School Attended : 
Community Where High School Located : 
GPA : 
Rank in Class : 
Class Size : 
College Attended after High School, if any : 
GPA : 
Academic Honors & Accomplishments : 
School & Community Activities
(please note any leadership positions) : 
Talents, Hobbies & Interests : 
Photo/Resume/Letter of Recommendation


LEGACY INFORMATION
Alpha Xi Delta Relatives (check all that apply) : 
 Mother/Step Mother
 Grandmother/Step Grandmother
 Sister/Step Sister
 Aunt
Name of Alpha Xi Delta Relative : 
Her Initiating Chapter : 
Address : 
Phone : 
Name of Alpha Xi Delta Relative : 
Her Initiating Chapter : 
Address : 
Phone : 
Name of Alpha Xi Delta Relative : 
Her Initiating Chapter : 
Address : 
Phone : 
Other Greek Influences : 


RECOMMENDATION INFORMATION
I recommend this woman : 
 Yes
 No
Number of years I have known this woman : 
Comments : 


FORM COMPLETED BY:
First Name : 
Middle Name : 
Last Name : 
Preferred Name : 
Address : 
Membership Status : 
 Alumna
 Collegian
Initiating Chapter : 

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