The National Leadership Honor Society Membership Form

Omicron Delta Kappa was the first college honor society of a national scope to give recognition and honor for meritorious leadership and service in extracurricular activities and to encourage development of general campus citizenship. Through membership in OΔK, you enter the ranks of over 300,000 women and men whose peers recognize them as scholars and leaders.


To be considered for membership, please fill out the following form and submit to your College/University Circle's Circle Coordinator. Please note that this form, fees, and participation in an induction ceremony are all prerequisites for membership in Omicron Delta Kappa.
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This membership application form is only one component of the membership selection process. Please contact your local Circle Officers about deadlines and other possible additional Circle requirements. The national membership fee is $88.00. Individual circles may charge an additional amount or local dues.


Fields with a red asterisk * are required fields.

The information in this application has been selected by the circle to which you are applying. You should consider all items after the Personal Information section as required since the circle has requested those questions be part of their application. Failure to submit any information requested by the circle in the subsequent sections, may lead to denial of the application. Please check with your circle leadership if you have any questions about what is required.


Student ID

Initiation Data

* College/University Name:
* Initiation Class: Junior
Senior
Graduate Student
Faculty/Staff
Alumni
Honoris Causa

Personal Data

* Salutation: Mr.
Mrs.
Miss
Ms.
Mx.
Dr.
* First Name
Middle Name (complete or initial)
* Last Name
Suffix (Jr., III, etc.)
Maiden or Previous Name:

Please list your name as you would like to have it appear on the certificate. For example: John Q. Public or Unis Teodora States would be acceptable. A maximum of 25 characters including spaces and punctuation.

Your name as it should appear on the membership certificate:
Preferred Name:
* Permanent Home Address:
* City
* State
* Zip Code
* Permanent Home Phone:
* Cell Phone:
* Personal E-mail address:
* School E-mail address:
* Birth Date (MM/DD/YYYY):

Omicron Delta Kappa does not discriminate on the basis of gender identity or expression. In order to track the effectiveness of our recruiting efforts and ensure we consider the needs of all our members, please select one of the following options if you are comfortable in doing so.

Gender: Male     Female     Non-Binary
Are you an OΔK Legacy?

A legacy is a member of your family inducted into OΔK at any circle, in any year, even if that circle no longer operates. It is important for our organization to note family membership connections.

Do you have a relative who is a member of OΔK? If yes, list the relative's name including maiden name if applicable:
School name of OΔK relative:
Graduation year of OΔK relative
Relationship with OΔK relative
Please describe how you are related to the relative (example, mother/father, sibling, etc.):

Academic/Professional Data

*Major:
2nd Major:
* Cum GPA:
* Grading scale:(3.0 or 4.0)
* Anticipated Graduation Date (MM/YYYY)

Employment

Current Employment Title:
Current Employer:
Current Employer Address:
Current Employer City, State, Zip:
Current Employer Country:
Current Employment/Business Email:

Please list other colleges attended:

Please list the last three colleges or universities from which you received degrees, the date (month/year) of the degree, and degree earned (for example: B.A., B.S., M.Ed., Ph.D.)

Name of College/University: Graduation (MM/YYYY): Degrees Earned:
(BA, MA, PhD, etc)
Field:
(History, Engineering, etc)

Pin Selection

* What type of pin would you prefer?
Traditional
1914
Laurel Crowned

OΔK Phases

* Please select each of the OΔK Phases in which you are active: Scholarship
Athletics
Campus Service
Communications
Art
What is your anticipated graduation month (MM/YYYY)?
Please list your Activities and Leadership Positions for the Scholarship Phase
Please list your Activities and Leadership Positions for the Athletics Phase
Please list your Activities and Leadership Positions for the Campus or Community Service, Social, Religious Activities and Campus Government Phase
Please list your Activities and Leadership Positions for the Journalism, Publications, Speech, and the Mass Media Phase
Please list your Activities and Leadership Positions for the Creative and Performing Arts Phase
Please list your Significant Honors and/or Achievements
Describe your most significant leadership experience while attending college/university (250 words max)
What do you hope to achieve through your membership in Omicron Delta Kappa?
What is your personal leadership philosophy? (250 word max)
What is your T-shirt size (XS, S, M, L, XL, 2XL, 3XL)?
Please list in detail your college organization memberships, leadership positions held, as well as awards and honors received. Do not include high school activities. Be certain to indicate the years for each item listed (for example, indicate if you were an RA, CA, or member of an organization during the 2016-17 academic year and the 2017-18 academic year).
Please list and describe your Leadership Positions affiliated with on-campus employment/student work program. (limit 250 words)

Terms and Conditions
I am applying for membership in Omicron Delta Kappa Society, Inc. through the circle (chapter) at the institution identified in this application. By submitting this form, I authorize the advisors, officers, and members of the specific circle to review and discuss my academic record including my current grades and academic standing, co-curricular and leadership activities, and class standing (junior, senior, graduate student, faculty/staff, alumni, or honorary) submitted herein for consideration. I understand that Omicron Delta Kappa requires this authorization because I seek membership in the national organization. I further understand and authorize the advisors of this circle to request proof of my grades and class standing as permitted by the institutional policies where the circle is chartered at the time of this application.

By submitting this form, I also agree to receive communications from Omicron Delta Kappa and its duly authorized personnel. These communications will include, but are not limited to, electronic and printed materials. Please refer to our Privacy Policy http://odk.org/privacy-policy/ for details.