Business and Information Technologies Department Phi Beta Lambda

Membership Application

First Name: ______________________________________ Last Name: _________

Preferred Name: Gender: ________Male ________Female

Date of Birth: _____/______/________ Phone Number: (___________)_____________- ___________________

Email: Home Town: _________

Expected Year of Graduation: Classification: ________

Major: GPA Range: ______2.5 ______3.0 ______3.5 _____Above 3.5

Career Goal(s)/Interest(s): _________ Were you a FBLA member in high school? ______Yes ______ No

Are you a returning member? ______Yes ______No Recruited by: _________

How did you hear about us? _________

Place of Employment __________________________________________________________________________________________________

By completing this form, I certify the following: I have met all eligibility requirements for Phi Beta Lambda, and have been extended an invitation for membership in my local chapter. I believe in and support the purpose of the organization as stated in the Phi Beta Lambda constitution, adhere to the moral standards of the organization, and currently enjoy the full rights of citizenship, freedom, and privileges of my country. Therefore I do solemnly promise to uphold the standards of Phi Beta Lambda, and to make this object and aim foremost in my mind, and I do solemnly pledge allegiance to my fellow members and promise to aid them in all worthy endeavors.

Signature _____________________________________________________________________ Date ___________________________________

Annual Lump Sum: $34 Payment Plan: $17 (Payment1) $17 (Payment 2)

Make checks payable to: Future Business Leaders of America Cash /Check# __________

Membership Dues