APPLICATION FOR OMEGA CHI EPSILON

I. Personal Information

Name:____________________________________ P.O. Box:________________________

Campus Phone:_____________________ Permanent Phone:________________________

Email Address:_____________________ Do you read email regularly?_______________

II. Scholastic Information

Class Standing (Junior or Senior):____________Overall GPA:_________ChE GPA:__________

Number of ChE courses successfully completed:_________Expected Grad. Date:___________

List any academic awards and honors you have received:

______________________________________________________________________________

______________________________________________________________________________

List all ChE classes you have taken and the grade you received:

______________________________________________________________________________

______________________________________________________________________________

III. Extracurricular Activities:

List the activities, projects, and organizations you have been involved with.  Please indicate any offices
you have held during the duration of your involvement.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

List any research, cooperative, or internship experience.

______________________________________________________________________________

______________________________________________________________________________

III. Other Information

List any other information that you feel is important for us to know so we can better evaluate your
potential for contribution to Omega Chi Epsilon.

______________________________________________________________________________

______________________________________________________________________________
PLEASE RETURN THIS FORM TO OUR BOX IN THE CHE LIBRARY, 1st FLOOR
Note: Meeting the minimum required GPA does not guarantee initiation