PAUL G. BLAZER HIGH SCHOOL BETA CLUB 2020
APPLICATION FOR MEMBERSHIP
NAME:________________________________________________________________
Please print exactly as you would like your name to appear in the induction program.
ADDRESS:_____________________________________________________________
STREET ADDRESS CITY ZIP CODE
TELEPHONE NUMBER:_________________________________________________
GRADUATION YEAR:________________
CURRENT MATH TEACHER:________________________ PERIOD:__________
You must have a cumulative GPA of 3.2 or higher at the present time. You must get verification from the counselor’s office. (Ms. Howard, Mrs. Ingram or Mr. Carroll)
Current Cumulative GPA: __________
Counselor Verification:________________________ Date:__________
Beta club is an honorary, active service organization open to sophomores and juniors with a 3.2 or higher GPA. In order to maintain membership, you will be required to attend the induction ceremony, earn a designated number of service project points (currently 15 per year), to maintain a minimum 3.2 GPA, and to uphold those qualities representative of Beta Club members. You will also be required to pay annual membership dues (currently $5 after the initial dues).
I understand the conditions of maintaining membership in the Paul G. Blazer High School chapter of the National Beta Club.
Student’s Signature: __________________________________________________
Date: _______________________________
PLEASE RETURN THIS COMPLETED FORM AND THE CURRENT MEMBERSHIP DUES OF $20 TO MRS. HACKNEY BY Wednesday, January 29, 2020. (Make checks payable to Paul Blazer High School.) YOU MUST ATTEND THE INDUCTION CEREMONY, exact date, time and location to be determined later. We are currently planning for March 11 at 4:00.