Phi Alpha National Social Work Honor Society

MU DELTA CHAPTER OF THE PHI ALPHA NATIONAL SOCIAL WORK HONOR SOCIETY SOCIAL WORK DEPARTMENT UNIVERSITY OF SOUTHERN INDIANA EVANSVILLE, INDIANA 47712

As stated in the preamble, the purpose is "to provide a closer bond among students of social work and promote humanitarian goals and ideals."

CRITERIA

1. Must be a student enrolled in the MSW program. 2. Must have earned a minimum overall GPA of 3.875. 3. Must have completed at least 12 hours of social work classes. 4. Fee of $50.00 (must be check or money order made out to Phi Alpha and is non- refundable.) *Attendance at the initiation ceremony (March 23rd, 2017 4:00) is required for membership.

APPLICATION FORM (Please TYPE)

NAME: ______

PREFERED MAILING ADDRESS: ______

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PHONE #: ______

EMAIL ADDRESS: ______

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USI Completed Hours: ______

USI CUMULATIVE GPA: ______

PRINT YOUR NAME AS YOU WANT IT TO APPEAR ON YOUR CERTIFICATE

First Name MI Last Name

PLEASE RESPOND TO THE FOLLOWING QUESTIONS IN THE SPACE PROVIDED. IF NEEDED, ANSWER THE QUESTIONS ON A SEPARATE SHEET AND ATTACH IT TO YOUR APPLICATION. (ALL FORMS MUST BE TYPED)

1. Discuss any formal or informal leadership activities you are engaged in as a social work student within the university or your community.

2. How do you connect with other social work students within the university or community to promote humanitarian goals in service to others?

3. How do you hope to contribute to the Social Work profession to foster the purpose of Phi Alpha Honor Society which is "Through knowledge--the challenge to serve"?

This completed Application and Fee of $50.00 must be turned in to Jara Dillingham or John Paulson in the Social Work Department by February 10, 2017.

SIGNATURE DATE: