THE DELTA KAPPA GAMMA SOCIETY INTERNATIONAL
Xi Chapter
Louisville, Kentucky
THE DELTA KAPPA GAMMA SOCIETY INTERNATIONAL
Xi Chapter
Louisville, Kentucky
Xi Membership Dues 20__ - 20 __
Xi Membership Dues 20__ - 20 __
Name ________________________________________
Name ________________________________________
______ Active Member s Dues
$ 80.00
______ Active Member s Dues
$
______ Reserve Members Dues
$ 41.50
______ Reserve Members Dues
$
Additional Donations for Xi Chapter
Additional Donations for Xi Chapter
Grant-in-Aid
$__________
Grant-in-Aid
$__________
Permanent Grant-in-Aid
$__________
Permanent Grant-in-Aid
$__________
Xi Chapter Scholarship
$__________
Xi Chapter Scholarship
$__________
Additional State and International Donations
Additional State and International Donations
World Fellowship
$__________
World Fellowship
$__________
State Scholarship Fund
$__________
State Scholarship Fund
$__________
Total
$__________
Total
$__________
Please return this form and money to:
Barbara Jacobs
3713 Tuesday Way
Louisville, KY 40219
Please return this form and money to:
Barbara Jacobs
3713 Tuesday Way
Louisville, KY 40219
DEADLINE—OCTOBER 1, 20 __
DEADLINE—OCTOBER 1, 20 __
(Barbara will also accept dues at the picnic.)
(Barbara will also accept dues at the picnic.)