IB 361
7/08 DELTA OMICRON
(PP,ES,Nat.IVP) INTERNATIONAL MUSIC FRATERNITY
Collegiate
Chapter Roster
Twice each year, in
the fall and in the spring after
officers are elected, the chapter secretary prepares 3 COPIES and sends them
to the Province President. Refer to chapter president's IB 351, check
list, for specific due dates.
DATE
_______________________________ CHAPTER
__________________________________________
SCHOOL
_____________________________ CITY/STATE
________________________________________
CHAPTER MEMBERSHIP SUMMARY
|
Collegiate
Membership |
Fr____ |
Soph____ |
Sr____ |
Gr____ |
Total_______ |
|
|
Prospective
Members |
Fr____ |
Soph____ |
Sr____ |
Gr____ |
Total_______ |
Planned
Initiation Date: ___________ |
SPRING TERM ONLY:
Total Membership Minus Graduating Seniors: ___________________
HEAD OF
Title (i.e., Dean,
Chair, etc.) ________________ Dept. Phone ( )__________________________________
CHAPTER ADVISER _______________________________________________________________________
Address
_____________________________________________________ Phone( )__________________
E-Mail
______________________________________________________ FAX ( ) ___________________
FACULTY SPONSOR _____________________________________________ Member of
DO SAI
MPE PMA ?
School Address
________________________________________________ Phone(
)_________________
Home Address
________________________________________________ Phone(
)_________________
E Mail
______________________________________________________ FAX (
)__________________
President ___________________________________________
Email ________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Summer Email _________________________________ Cell Phone ( ) ______________________
I Vice Pres. __________________________________________ Email
________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
II Vice Pres. __________________________________________ Email
________________________________
Fr. So. School Address
_________________________________ Phone (
) ___________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Secretary ___________________________________________
Email ________________________________
Fr. So. School Address
_________________________________ Phone (
) ___________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) ___________________________
Treasurer ___________________________________________
Email ________________________________
Fr. So. School Address
_________________________________ Phone (
) ___________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Music Activities
______________________________________ Email
________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Publicity ____________________________________________
Email ________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Warden ____________________________________________
Email _________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Historian ____________________________________________
Email ________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Chaplain
___________________________________________ Email
________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Rush Chair
_________________________________________ Email
________________________________
Fr. So. School Address
_________________________________ Phone (
) __________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) __________________________
Scholarship Chair
____________________________________ Email
________________________________
Fr. So. School Address
_________________________________ Phone (
) ___________________________
Jr. Sr.
Gr. Home Address _________________________________ Phone (
) ___________________________
** Please attach a list or spreadsheet of
all other officers and members to this form.
Include addresses and phone number for all members.