Life Membership Payment Plan

Graduating Seniors, Alumni and Honorary Members of Tau Beta Sigma are eligible for Life Membership. The Life Membership fee is $650*, 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 a 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:

$ 112.50

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: $112.50 Monthly for six months