FLORIDA STATE UNIVERSITY

 

PHI THETA KAPPA SCHOLARSHIP APPLICATION
 

 

  1. Name___________________________________________________________________________________________
        (Please Print)           Last                                                                    First                                                        M.I.                     

  2. Social Security Number    ___    ___    ___              ___     ___              ___    ___    ___     ___


    3.             
  3. PTK Chapter __________________________________________________ Length of Membership ____________



  4. Office(s) held: ___________________________________________________________________________________


  5. Other organizations in which you are active: _______________________________________________________


    6. __________________________________________________________________________________________________

    __________________________________________________________________________________________________

    __________________________________________________________________________________________________

  6. Community Service activities: ____________________________________________________________________


    7. __________________________________________________________________________________________________

    __________________________________________________________________________________________________

    __________________________________________________________________________________________________

  7. Special skills/talents: ____________________________________________________________________________


    8. __________________________________________________________________________________________________

    __________________________________________________________________________________________________

Please return to:

Florida State University
Office of Admissions
2500A University Center
Tallahassee, Florida 32306-2400