Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195 Of Zeta Phi Beta Sorority, Inc. Phi Kappa Zeta Chapter Woodbridge, VA Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195 About Zeta Phi Beta Sorority, Inc. and the Phi Kappa Zeta Chapter Zeta Phi Beta Sorority Inc. was founded January 16, 1920 on the campus of Howard University in Washington, D.C. Five coeds, Arizona Cleaver, Pearl Neal, Myrtle Tyler, Viola Tyler and Fannie Pettie were encouraged by Charles Robert Taylor and A. Langston Taylor, members of Phi Beta Sigma Fraternity, Inc. to form a sister organization. The sorority’s principles are Scholarship, Sisterly Love, Service and “Finer Womanhood.” Phi Kappa Zeta Chapter (PKZ) was chartered on December 5, 2007 in Woodbridge, VA by eight women ranging in all professional backgrounds and age groups. PKZ programming primarily focuses on education/literacy, meeting the needs of women and children, and health/wellness. The Archonette Club The Phi Kappa Zeta Archonette Club charted in 2008. In 2008 four young ladies were the first to become Archonetts in Prince William County. These High School aged young ladies demonstrated an interest in the goals and ideals of Scholarship, Sisterly love and community service. In addition to an opportunity to join the Archonette Club the program encourages young ladies to become future members of Zeta Phi Beta Sorority, Inc. Eligibility for the Archonette Club Applicants must meet the following Eligibility Requirements: Residency in Prince William County; High school student ages 14-18; Minimum GPA of 3.0 (on a 4.0 scale) Application packets must be received by January 4, 2013. Activities shall begin shortly thereafter. Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195 Please Print Legibly Applicant’s Name: _________________________________________________________________ Address: ________________________________________________________________________ Cell Phone: ________________________ Email: ________________________________________ Date of Birth: _______________________________ Grade as of September 2012: _____________ Name of School Currently Attending:_________________________________________________________________ How did you hear about the Archonette Club? ____________________________________ Applicant’s Hobbies/Interests: ___________________________________________________________ Applicant’s Honors/Awards: ___________________________________________________________ Parent/Guardian Names: ___________________________________________________________ Address of Guardian: ___________________________________________________________ Parent/Guardian Home Phone: ________________________ Cell Phone: _______________________ Work Phone: ________________________ Email: ___________________________ Preferred Method of Contact: ☐Home ☐Work ☐Cell Preferred Time to Contact: ☐Day ☐Evening Emergency Contact (Name, Phone, Relationship): _____________________________________________________________________________________ Please list any allergies or known medical conditions: _____________________________________________________________________________________ If you do NOT eat any of the following, please check the box: ☐Poultry ☐Pork ☐Beef ☐Fish ☐Dairy Please list any known medical problems: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195 Requirements Please respond to the following question: “Why do you feel you would be a great candidate for The Archonette Club?” Two Letters of Recommendation (Professional and Personal) Grade Verification Applicant must submit her transcripts with this application. The minimum overall Grade Point Average (GPA) requirement for participation in The Archonette Club is 3.0 (on a 4.0 scale). Parent/Guardian Initial that you have read and understand this requirement:____________ Certification I hereby certify that: All information submitted in the application is true and correct. I give the Phi Kappa Zeta Chapter permission to verify any information contained in this package, as necessary. Applicant Signature: _____________________________________ Date: ___________________ Parent/Guardian Signature:__________________________________ Date: ___________________ Permission/Release I hereby grant permission to use my name, comments, pictures, or photography for public relations, advertising, or any other lawful purposes, and I waive any right to inspect or approve the finished version(s) including written copy that may be created in conjunction therewith. I understand that information from my official transcript(s), scholarship application, and submitted essay may be used. My child, _________________________________________________, has my permission to become an active member of “The Archonette Club” of Zeta Phi Beta Sorority, Inc. Applicant Signature: _____________________________________ Date: ___________________ Parent/Guardian Signature:__________________________________ Date: ___________________ Please note that a $30 participant fee needs to be received with this application Payments should be made payable to Phi Kappa Zeta Chapter Participant fee is non-transferable and non-refundable. Thank you for your interest in The Archonette Club. We hope to see you in January at our Program orientation. If you have any questions, please feel free to contact the Archonette Chair: Ms. Tanisha T. Capers || archonetteclub@phikappazeta1920.org || 857-366-0918 Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195 Recommendation Form Applicant Name: _________________________________________________________________ How long have you known the applicant and in what capacity have you known her? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ What words come to mind when you think of the applicant? _____________________________________________________________________________________ Please circle the number which best applies to each area: (1- Needs Improvement 2-Average 3-Above Average 4-Outstanding) Integrity 1 2 3 4 Contribution to School or Community 1 2 3 4 Character 1 2 3 4 Relationship with Peers 1 2 3 4 Academic Motivation 1 2 3 4 Positive Attitude 1 2 3 4 Responsibility 1 2 3 4 Please comment briefly about the applicant’s personality, character, academic aspirations, etc. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Signature: ____________________________________________ Title: _____________________ Please place this form in a sealed envelope, sign the flap, and return the envelope to the applicant to be mailed with their application. Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195 Recommendation Form Applicant Name: _________________________________________________________________ How long have you known the applicant and in what capacity have you known her? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ What words come to mind when you think of the applicant? _____________________________________________________________________________________ Please circle the number which best applies to each area: (1- Needs Improvement 2-Average 3-Above Average 4-Outstanding) Integrity 1 2 3 4 Contribution to School or Community 1 2 3 4 Character 1 2 3 4 Relationship with Peers 1 2 3 4 Academic Motivation 1 2 3 4 Positive Attitude 1 2 3 4 Responsibility 1 2 3 4 Please comment briefly about the applicant’s personality, character, academic aspirations, etc. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Signature: ____________________________________________ Title: _____________________ Please place this form in a sealed envelope, sign the flap, and return the envelope to the applicant to be mailed with their application. Complete and return all forms by January 4, 2013 to: Zeta Phi Beta Sorority, Inc. Archonette Club c/o Phi Kappa Zeta Chapter P.O. Box 6369| Woodbridge, VA 22195