Cuyahoga Community College
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Application for Phi Theta Kappa Membership Fee Support
Note: this is a reimbursement scholarship. Funding is limited and therefore an award is not guaranteed.
Fields marked with
*
are required
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First Name:
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Last Name:
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Tri-C ID:
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Address 1:
Address 2:
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City:
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State:
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ZIP Code:
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Phone:
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Preferred Email:
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Scholarship Amount Requested:
Select...
$15
$25
$35
$45
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Chapter:
Select...
Alpha Epsilon Eta (ΑΕΗ), Eastern Campus
Alpha Zeta Delta (ΑΖΔ), Metropolitan Campus
Chi Omega (ΧΩ), Western Campus
Beta Upsilon Beta (ΒΥΒ), Westshore Campus
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Briefly describe, citing specific reasons, why you wish to join Phi Theta Kappa:
*
Briefly describe, citing specific reasons, why you wish to receive this scholarship:
Enter the code shown
below
to the right
By submitting this scholarship application, I affirm that I will actively participate in and contribute to the welfare of the Phi Theta Kappa chapter I join. At a minimum, I will attend at least two chapter member meetings per semester while I am a student at Tri-C. I also promise to hand-write and mail a Thank You note to the Tri-C Foundation for funding this scholarship.