Jacksonville Alumnae Panhellenic Membership Application

(Once completed, please be sure to hit "Submit" button at the bottom.)

Name: 

First

Last

Address: 

Street

State

City

ZIP

Sorority: 

College/University: 

Please make check payable to Jacksonville Alumnae Panhellenic Association and mail to: 

JAPA Treasurer

6749 Mopsy Lane

Jacksonville, FL 32210

Thank you for your interest and participation! 

If you have any questions about membership, please call Carol Taylor at 262-1892 or email at taylor1825@bellsouth.net.

Email address: 

Preferred method of contact:

Maiden

Number of years in JAPA

Spouse's Name: 

Home phone: 

Work phone: 

Occupation: 

Employer: 

Membership Dues:$25

Scholarship Donation:  $

in memory of

in honor of

Directory Ad: $

business card @ $10

1/2 page @ $20

full page @ $40

(Directory Chair will contact you regarding copy.)

Total JAPA Support:     $

Scholarship Fund Recognition Levels:

Supportive Sister$15 - $24

Generous Greek Giver$25 - $49

Panhellenic Patron     $50 - $74

Athena Society   $75 +

Birthdate:

Month

Day

New MemberRenewing Member

FLGA

(Please select one)Alpha Chi OmegaAlpha Delta PiAlpha Epsilon PiAlpha Gamma DeltaAlpha Omicron PiAlpha PhiAlpha Sigma AlphaAlpha Sigma TauAlpha Xi DeltaChi OmegaDelta Delta DeltaDelta GammaDelta Phi EpsilonDelta ZetaGamma Phi BetaKappa Alpha ThetaKappa DeltaKappa Kappa GammaPhi MuPhi Sigma SigmaPi Beta PhiSigma Delta TauSigma KappaSigma Sigma SigmaTheta Phi AlphaZeta Tau Alpha

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