University Honors Center Office Use Only Membership Petition

*Petitions to be considered for invitation to University Honors Center supported honors societies may only be submitted for the semester in which the student believes they are eligible. *In any semester, petitions may be submitted no earlier than the 12th class day. *Petitions for Alpha Lambda Delta, or must be submitted no later than the last day to apply for an undergraduate degree; students will receive notification of their status no later than five (5) working days after the last day to apply for an undergraduate degree. *Petitions for must be submitted no later than ten (10) working days before the last day of class; students will receive notification of their status no later than five (5) working days before the last day of class. *Petitions submitted before the acceptance date or after the deadline will not be considered. *Refer to the UT Academic Calendar for all relevant dates (registrar.utexas.edu/calendars).

EID: ______Society Petitioned: ______First Name: ______Last Name: ______Email Address: ______First Semester at UT: ______Expected Graduation Date (Month/Year): ______Have you applied to graduate this semester? (circle one) YES NO Will you apply to graduate this semester? (circle one) YES NO Is your UT contact information up to date & correct? (circle one) YES NO (More information: utdirect.utexas.edu/apps/utd/all_my_addresses) Have you restricted your UT directory information? (circle one) YES NO (More information: registrar.utexas.edu/students/records/restrictmyinfo)

UT Direct Grade Report Information (utdirect.utexas.edu/apps/student/gradereport))

College(s) Major(s) ______

Hours Undertaken Hours Passed GPA Hours Grade Points GPA Current Semester ______Current Cumulative ______

Transfer Hours: ______UT Hours Undertaken: ______Total Hours Undertaken: ______

Additional Materials (include with petition form)

1) On a separate typed document, please explain why you believe you are eligible for invitation during this election/induction cycle. Make sure this page is labeled with your name and EID.

2) Attach a copy of your academic summary from the Office of the Registrar (official transcript not required; see registrar.utexas.edu/students/records/summary for more information).

I certify I have completed all instructions and the information presented here is complete and accurate. I accept that falsifying information on this form is grounds to be excluded from consideration to join the society petitioned. I authorize an administrator of the University Honors Center to access my student records from UT's Office of the Registrar to verify this information and present it to society officers.

______Signature Date Return all materials to the University Honors Center CRD 23 (accessible via the north entrance of the Carothers Residence Hall)