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Beta Theta Pi Associate Member Application
Beta Theta Pi Associate Member Application
Please complete the following application
OR
send an email to Tom Bremer at
twb5155@psu.edu
Personal Info
First Name
Last Name
Email
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Date of Birth
Student ID Number
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Street Address
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State
Please Choose
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Street
City
State
Please Choose
Not in the US
Alabama
Alaska
Arizona
Arkansas
Armed Forces Europe
Armed Forces Pacific
Armed Forces the Americas
British Columbia
California
Colorado
Connecticut
Delaware
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
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Zip Code
Phone
School Information
Name of School
Current Year
Freshman
Sophomore
Junior
Senior
Transfer Student
Yes
No
Class/Rank
H.S. GPA
College GPA
Major
Legacy of Beta Theta Pi
Yes
No
Have you previously pledged or joined another Fraternity
Yes
No
If Yes, which Fraternity?
Why are you no longer a member?
Honors, Achievements, Awards
Community Service/Extracurricular Activities
What will you bring to Beta Theta Pi?
What do you want to gain from your Fraternity experience?
What makes you a great Associate Member candidate?
What event in your past has shaped your character the most?
Please feel free to attach additional pages and / or a resume.
FYI - We will be cross-referencing your stated GPA with school records.
Any questions or concerns?
Contact Tom Bremer at
twb5155@psu.edu
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