Life Membership Payment Plan

Graduating Seniors, Alumni and Honorary Members of Tau Beta Sigma are eligible for Life Membership. The Life Membership fee is $500*, payable in full before membership is processed.

Life Membership grants the following privileges:
Receive a Tau Beta Sigma Life Membership Card, Certificate and Pin
Receive a current year's membership in the Tau Beta Sigma Alumni Association
Receive an online subscription to The PODIUM

*A $25.00 administrative fee will be included in the total cost of the plan to cover credit card charge fees and additional administration for the payment plan option. Once a payment plan is started, there will be no refunds, and Life Membership will not be granted until the final payment is processed. To make changes to monthly payment plan, please contact National Headquarters at 405-372-2333.
NOTE: The date your account will be charged each month is based on the date of submission of this form.

Donation Amount:

$ 87.50

Monthly for six months

Recipient's Full Name

Maiden Name (if applicable)

Address

Address 2

City

State

Zip Code

Email Address

Home Phone

Cell Phone

Occupation

Former Chapter

College / University

Graduation Date

Year of Initiation

Yes No

Who is the gift from and where should it be shipped?

Select Payment Method

Authorize.Net - eCheck
Authorize.Net - Credit Card

Personal Info

First Name *

Last Name

Email Address *

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Billing Details

Country *

Address 1 *

Address 2

City *

State *

Zip / Postal Code *

Donation Total: $87.50 Monthly for six months