PTK main page | About PTK | Membership
Deadline November 13, 2009 at 5 p.m.
Deliver applications to Velda Arnaud, Advisor, Building 2, Room 108D
or the chapter office in Building 17, Room 312
| Name | ___________________________________ | Date | ______________________________ |
| Number of family living in household | ___________ | Phone | ______________________ |
| Ages of children | ___________________________ |
| Allergies or dietary restrictions |
________________________________________________ |
Please write a brief description about how this gift will benefit the nominee. (Please print clearly.)
| _____________________________________________________________ |
| _____________________________________________________________ |
| _____________________________________________________________ |
| _____________________________________________________________ |
| _____________________________________________________________ |
| _____________________________________________________________ |
| _____________________________________________________________ |
When can you pick up your basket?
______ Tuesday afternoon 11/24 between 2-4 p.m. in the southwest corner of the cafeteria.
If you have questions, call Velda Arnaud at 463-5682, or e-mail arnaudv@lanecc.edu or Contact the Phi Theta Kappa Office in Building 17, Room 312,
Phone: 463-3238;
E-mail: SigmaZeta@lanecc.edu