IB 364

7/08

(ES)

DELTA OMICRON

INTERNATIONAL MUSIC FRATERNITY

 

Chapter Payment Form

 

Use this form for all chapter payments.  Make checks to Delta Omicron Fraternity.  All payments should be sent directly to the Executive Office:  Julie H. Wright, Executive Secretary, P.O. Box 752, Jefferson City, TN 37760.  Make 2 copies of this form. Send one to the Executive Secretary.  Retain one copy in the chapter treasurer’s files.

 

CHAPTER ______________________________________________________________

 

NAME & CONTACT INFORMATION FOR REPORTING OFFICER:

 

                NAME & OFFICE__________________________________________________

                MAILING ADDRESS_______________________________________________

                _________________________________________________________________

                PHONE __________________________________________________________

                EMAIL ADDRESS _________________________________________________

 

Payments:  Please indicate the amount of payment for the specific fee or purchase.

 

National Fees:

Annual National Dues  ($30 per member)

Attach IB 368

 

____________________

 

Due: October 31

Optional Life Membership Dues ($300)

Attach IB 314

 

____________________

 

Service Fee ($25.00)

____________________

Due: October 31

Founders Day Pennies ($.99 per member)

____________________

Due: April 1

Endowment Investment ($3 per member)

____________________

Due: April 1

Conference Investment ($200 per chapter)

____________________

Due: April 1

 

 

New Member Fees:

Prospective Member Fees ($20 x ____PMs)

Attach IB 437

 

____________________

 

Due following Pledge Ceremony

Initiation Fees ($70 x _____PMs)

Attach IB 337 per PM

 

____________________

 

Due 2 weeks before Initiation

 

Other:

Star of Delta Omicron ($12.00 each)

Attach IB 378

 

____________________

 

Due: March or April

Senior Honor Pin ($27.00 each)

Attach IB 372

 

____________________

 

Due: February or March

Supplies Order – Attach IB 308

____________________

 

Jewelry Orders – Attach IB 336

____________________

 

TOTAL ENCLOSED:

 

____________________

 

 

Mail to Executive Secretary:

Julie H. Wright

P.O. Box 752

Jefferson City, TN 37760