Special Initiate Petition - Kappa Alpha Order

Person Submitting Form

Full Name*

First and last name of person submitting form

Email*

Email Address of person submitting form

Phone*

Phone number of person submitting form. Cell preferred.

Potential Special Initiate Information

Full Name*

Full name of potential special initiate(i.e. Mr. James Ward Wood, Jr.)

Date of Birth*

Date of Birth of potential special initiate

Home Address*

Street Address Address Line 2 City State ZIP Code

Home address of potential special initiate

Email*

Email address of potential special intiate

Phone*

Phone Number potential special initiate. Cell preferred.

Legacy Relationships

If son, father, grandfather, uncle, etc., is a KA?

Date of Initiation*

Initiation date of potential special initiate

Chapter*

Chapter to initiate special initiate

Recommendations

Upload Photo of Potential Special Initiate*

Max. file size: 50 MB.

Headshot or family photo preferred

Recommendation Letter from Active Chapter*

Max. file size: 50 MB.

Upload a letter of favorable recommendation from the Active Chapter.

Recommendation Letter from Alumnus Advisor*

Max. file size: 50 MB.

Upload a letter of favorable recommendation from the Alumnus Advisor.

Recommendation Letter from the Province Commander*

Max. file size: 50 MB.

Upload a letter of favorable recommendation from the Province Commander.

Recommendation Letter from another KA Alumnus*

Max. file size: 50 MB.

Upload a letter of favorable recommendation from another KA Alumnus.

Chapter Acknowledgment

Once the Executive Council has approved the petition the initiation fee of $300 will be billed to the Active Chapter Account. Some special initiations are paid by alumni and they typically reimburse the active chapter. It takes up to two weeks to order the badge and 4-6 weeks to order the Shingle.

Phone

This field is for validation purposes and should be left unchanged.