IB 314

7/07

DELTA OMICRON

INTERNATIONAL MUSIC FRATERNITY

Life Membership Application

Life Membership entitles a member to receive The WHEEL and other Fraternity publications for life. It also exempts a member from payment of all future national annual dues and makes one a member in good standing for life, a requirement for eligibility for fraternity and foundation scholarships and grants. Payment for Life Membership may be made through the chapter or alumni club with which a member is affiliated, or it may be made directly to the Executive Office.

The Life Membership fee may be paid in either of two ways:

• The installment plan for graduating seniors or alumni: Under the installment plan, the cost is $30.00 national annual dues each year for 10 consecutive years. If college seniors pay dues in the fall term of their senior year and again in the spring term that they graduate, only eight (8) consecutive annual payments following graduation are required.

• The single payment plan: Members pay a one time payment of $300.

Attach this form to the Chapter Payment Form IB 364. Make all checks or money orders payable to DELTA OMICRON FRATERNITY. Send to the Executive Secretary.

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Julie H. Wright, Executive Secretary

Delta Omicron Fraternity

910 Church Street

Box 752

Jefferson City, TN 37760

I was initiated on __________________ into _____________________________ Chapter at

(approximate date) (collegiate chapter)

at _____________________________________________________________________________

(name of school ) (city, state)

I am currently affiliated with ________________________________________________________

(name of chapter or club: if applicable)

Enclosed please find: _____________________ Installment Plan $30.00

_____________________ Single Payment $300.00

Name ____________________________________________ National Number_______________

Address ________________________________________________________________________

Phone Number ( ) ________________ e-mail address: ____________________________