CONNECTIONS, is the National Alumni Directory of Phi Chi Theta. CONNECTIONS, is published and distributed annually to the National Chapters of Phi Chi Theta. Please take a couple of minutes to complete the form and send it to our National Office. Your information is important to us, and we want to hear from you. By completing this form, you will become part of our worldwide network that is available to all of our members.
PERSONAL INFORMATION

Name:

Address:

City, State Zip:

Country:

Daytime Phone:

Evening Phone:

E-Mail:

POST GRADUATE INFORMATION

Please Check the Appropriate Boxes:

I am/will be employed at:

    Company Name:

    Job Title:

I am seeking employment:
    Career Field:

    Geographical Location:

I am/will be attending graduate school:
    University/College:

    Degree/Area of Interest:

    Expected Graduation Date:

I am retired:
    Company Name:

    Job Title (before retirement):

PHI CHI THETA INFORMATION

University/College Attended:

Date of Graduation:

Chapter Name:

Membership Information (check all that apply):

    I am a member of an Alumni Chapter.
    I am interested in joining an Alumni Chapter in my area.
    I am interested in starting an Alumni Chapter in my area.
    I am interested in becoming an Alumni without a local affiliation.
Comments, Questions, Feedback:
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CONNECTIONS
Information Update Form