SIGMA GAMMA RHO SORORITY INC
SIGMA GAMMA RHO SORORITY, INC. CAMPAIGN 1922! REACTIVATION FORM Soror, THANKS for your renewed interest in the Sisterhood. We have missed you and welcome you back. Procedure for reactivating: 1. Provide your contact information below 2. Select the best membership option for you 3. Select the best payment option for you – payment covers all National, Regional, and Foundation assessments 4. Select an area of interest (optional) 5. Secure money order or cashier’s check and remit to Headquarters OR pay via credit card by fax or online. SECTION 1. – CONTACT INFORMATION:
Date (mm/dd/yyyy):
Name: (First Name)
Contact Address:
(Middle Name)
(Maiden Name) (City)
(Street Address)
Contact Phone:
(Last Name) (State)
(Zip Code)
Contact E-mail:
Last Chapter Active With:
SECTION 2. – SELECT THE BEST MEMBERSHIP OPTION (Check one): Remain a General Member and do not affiliate with a chapter Become a Member of a chapter but do not know the chapter(s) in my area – please contact the chapter(s) in:
[email protected] OR [email protected] OR [email protected] OR [email protected] OR [email protected]
Become a Member of a chapter and already know the chapter (Indicate chapter): AND remember to pay chapter dues directly to the chapter.
SECTION 3. – SELECT THE BEST PAYMENT OPTION (Check one): Option 1 Option 2 Option 3
IF FULL PAYMENT IS NOT RECEIVED CONSECUTIVELY, YOU WILL FORFEIT ALL INSTALLMENTS. NO REFUNDS.
1 installment of $375.00 2 consecutive installments of $187.50 – Due monthly 3 consecutive installments of $125.00 – Due monthly
SECTION 4. – SELECT AN AREA OF INTEREST (Check all that apply and/or list other): National Programs IT Team
Membership Other:
Social Media / Public Relations
SECTION 5. – PAYMENT INFORMATION (Check one): AN INSTALLMENT IS DUE WITH REACTIVATION FORM MADE PAYABLE TO SIGMA GAMMA RHO SORORITY, INC. Manual Payment Option: MONEY ORDER CASHIER CHECK Credit Card Payment Option: AMERICAN EXPRESS Name as it appears on Credit Card:
DISCOVER
MASTERCARD
VISA
Address associated with Credit Card: Credit Card Number:
Expiration Date:
3-digit Verification Code:
Signature:
Sigma Gamma Rho Sorority, Inc. Attn: Campaign 1922 1000 Southhill Drive, Suite 200 Cary, NC 27513-8630 Phone: 919-678-9720 SEND VIA FAX: 1-877-647-1918 Reactivate Online!! www.sgrho1922.org/campaign1922 Submit to HQ
Print Form
Date (mm/dd/yyyy):
Name: (First Name)
Contact Address:
(Middle Name)
(Maiden Name) (City)
(Street Address)
Contact Phone:
(Last Name) (State)
(Zip Code)
Contact E-mail:
Last Chapter Active With:
SECTION 2. – SELECT THE BEST MEMBERSHIP OPTION (Check one): Remain a General Member and do not affiliate with a chapter Become a Member of a chapter but do not know the chapter(s) in my area – please contact the chapter(s) in:
[email protected] OR [email protected] OR [email protected] OR [email protected] OR [email protected]
Become a Member of a chapter and already know the chapter (Indicate chapter): AND remember to pay chapter dues directly to the chapter.
SECTION 3. – SELECT THE BEST PAYMENT OPTION (Check one): Option 1 Option 2 Option 3
IF FULL PAYMENT IS NOT RECEIVED CONSECUTIVELY, YOU WILL FORFEIT ALL INSTALLMENTS. NO REFUNDS.
1 installment of $375.00 2 consecutive installments of $187.50 – Due monthly 3 consecutive installments of $125.00 – Due monthly
SECTION 4. – SELECT AN AREA OF INTEREST (Check all that apply and/or list other): National Programs IT Team
Membership Other:
Social Media / Public Relations
SECTION 5. – PAYMENT INFORMATION (Check one): AN INSTALLMENT IS DUE WITH REACTIVATION FORM MADE PAYABLE TO SIGMA GAMMA RHO SORORITY, INC. Manual Payment Option: MONEY ORDER CASHIER CHECK Credit Card Payment Option: AMERICAN EXPRESS Name as it appears on Credit Card:
DISCOVER
MASTERCARD
VISA
Address associated with Credit Card: Credit Card Number:
Expiration Date:
3-digit Verification Code:
Signature:
Sigma Gamma Rho Sorority, Inc. Attn: Campaign 1922 1000 Southhill Drive, Suite 200 Cary, NC 27513-8630 Phone: 919-678-9720 SEND VIA FAX: 1-877-647-1918 Reactivate Online!! www.sgrho1922.org/campaign1922 Submit to HQ
Print Form
