Application of Interest


Email Address:
Your Full Name
Your Email Address (ex : you@aol.com)
Home / Cellular Telephone Number
Complete Mailing Address (including city & state)
What is the nature of your inquiry?
Race (Statistical purposes only) African American/Black
Hispanic/Latina
Caucasian/White
American Indian
Native American
Asian
Other
Are you a registered voter? Yes
No
Are you employed? Yes
No
What is your sexual orientation? Lesbian
Bisexual
Heterosexual
Pansexual
How old are you? 18-20
21-25
26-30
30-35
35+
How did you hear of Kappa Xi Omega Sorority Inc? (choose all that apply) Web Search
Friend
Word of Mouth
Interest Social
Flyer
Email
Myspace
Other
Are you interested in the Kappa Xi Omega Sorority Inc Expansion Program? Yes
No
Maybe, I need for information
Would you be against traveling for membership intake? Yes
No
I am not sure
Are you active in your community? If so what projects are you active in?
What is the best time to contact you?
What is the best method of contact? Email
Phone
US Postal Mail
Please attach a recent photo of yourself

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For there is no friend like a sister In calm or stormy weather, To cheer one on the tedious way, To fetch one if one goes astray, To lift one if one totters down, To strengthen whilst one stands.