Print, complete and deliver this form to a current Sigma Tau Delta officer or pick up an application from the Faculty Advisor (GTM 250). Please do not email the information. Your application cannot be processed unless accompanied by the $50.00 initiation fee.


Chapter Information (to be completed by Sigma Tau Delta Officer)

School: Louisiana Tech University

Address: Ruston, LA 71272

Chapter: Rho Gamma

Sponsor: Dr. Dorothy Dodge Robbins

Telephone: (318) 257-4689

Email: drobbins@latech.edu

Reporting Officer:

Date Form Sent:

Amount Enclosed:



New Member Information (to be completed by applicant)

Name (as it should appear on membership certificate):


Social Security Number:


Home Address (permanent, not campus):


Email Address:


Anticipated year of Graduation:


Class Rank (undergraduate student, graduate student, or faculty):


Signature:



Date: