ALPHA KAPPA ALPHA SORORITY, INCORPORATED
NORTH ATLANTIC REGION
INSTRUCTIONS
Attach documentation to support request (i.e., letter of invitation, flyer, etc).
Email to Regional Director at constance.pizarro@comcast.net
(minimum ten (10) business days prior to event date).
Written approval is required PRIOR to participation.
Submit one form per step show request.
This form is NOT appropriate for Post-Initiation Activity.
The participant’s acknowledgement form must accompany the undergraduate step show participation request.
Today’s Date:
Chapter’s Name and School:
Chapter’s Mailing Address
City, State, Zip
Basileus: Phone: E-mail:
STEP SHOW INFORMATION
Date of Performance:
Location:
(Name of Facility) (Address, City, State, Zip)
Sponsoring Organization:
Purpose:
PRIZE
Trophy/Plaque Contribution to:
Cash Contribution to Chapter Budget
Graduate Advisor’s Name (please print or type):
Address, City, State, Zip:
Phone: Fax: E-mail:
Graduate Advisor’s Signature: Date:
DO NOT WRITE BELOW THIS LINE
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APPROVED NOT APPROVED
REGIONAL DIRECTOR’S SIGNATURE DATE
DATE MAILED FAXED VERBAL APPROVAL Form revised September 2010
ALPHA KAPPA ALPHA SORORITY, INCORPORATED
NORTH ATLANTIC REGION
PARTICIPANT’S ACKNOWLEDGEMENT FORM
Each participant must initial as acknowledgement of the following guidelines for step show performances.
General Guidelines
Each performance must be in good taste and not degrade another person or organization.
Performance attire must be approved by the graduate advisor.
The performance cannot contain the term or sound “skee wee” or its likeness.
The pinkie or its likeness cannot be a part of the performance.
No living, stuffed, man-made, or pictures of animals (i.e. frog, panther, bunny, etc.).
The shape of an ivy is acceptable (i.e., formed by the hands, a performance formation, etc.)
Each participant must be matriculating as a full-time student (previous semester and current).
Violations of the guidelines will result in withdrawal of privileges.
The Soror Completes this Section
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For the Regional Director Only
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Soror’s Name
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Current # of enrolled hours
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Soror’s Initials and Date
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Previous semester
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Overall
GPA
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Approval
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GPA
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# of hrs
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GRADUATE ADVISOR’S ACKNOWLEDGEMENT
Graduate Advisor’s Name (please print or type)
Graduate Advisor’s Signature Date
Form revised September 2010
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