Chapter Officer Reporting Form

Please refer to the Chapter Listing, which is updated weekly, to see if your newly elected chapter officer information has already been submitted to Headquarters. If it has not, Chapter Officers or Advisors may use this form to report up to six officers to Headquarters.

To report Chapter Officers that are no longer serving, please email their names, chapter and college to member.services@ptk.org.

Visit the Phi Theta Kappa Enrollment Form to ensure that you have submitted your graduate/transfer date, major and other important information to us. Completing and updating the Enrollment Form will help ensure that you will be considered for scholarships and that you will have access to exclusive membership benefits.

Answers that are required to complete this form are marked with an asterisk.

* College:

* Chapter:

* Date on which officer terms start:

* Date on which officer terms expire:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

To remove this Chapter Officer, check this box.

Name of Chapter Officer:

Position of Chapter Officer (ie, Vice-President):

Mailing Address:

City:


State: Zip:

Phone with Area Code:


Email Address:

Information Submitted By:

Date Submitted:

The officers reported above will receive periodic updates from Phi Theta Kappa regarding important events, deadlines, and news of interest.

If the information on this on-line form is complete and ready to be sent to Headquarters, press Submit. If you would like to clear the form and start over, or wish to complete the form at a later date, press Reset.