Order of Kush Honor Society: Chapter Activation Form.

Order of Kush International (OKI)

2008–2009 Chapter Activation Form

This form is the first step for activating your Order of Kush Honor Society Chapter for the 2008–2009 school year.

Chapters should be activated early in the school year to receive maximum benefit.
2008–2009 Order of Kush activations will end August 30, 2008.

Please allow 2 weeks for processing.
PURCHASE ORDERS ARE NOT ACCEPTED. PLEASE DO NOT SEND CASH.
Please make checks payable to Order of Kush International.

Step 1: Chapter Information

Check one:
Undergraduate Chapter (College or University)
Combined Undergraduate and Graduate Chapter (College or University)

Chapter Advisor Name
OKI ID#? New Advisor this year?
School
Chapter # (if not new chapter)
Street Address
City State Zip
School Telephone Number ext.
Fax Number
Advisor E-mail Address
Date of Membership Presentation Ceremony (if known)
Order of Kush Member Count Last Year (2005-2006 school year) (N/A if new or reactivating chapter)

Chapter Activation Fee:

$ 100

Step 2: If No Donor, Skip to Step 3.

Business or Individual Donation to Assist with Chapter Fees (Minimum Donation $100).
Donor contact information is required for tax receipt (donations made to OKI for Chapter fees are tax-deductible).

Donor Name
For business donations, provide contact name
Donor Address
City State Zip

This chapter has received a $ payment from a donor. That donation is being used to pay for the chapter activation fee. Any balance will be used for Order of Kush membership materials or Order of Kush specialty items. We agree that any funds not used by August 30, 2009, will go to OKI's Scholarship Fund for needy students so the full amount will remain tax deductible for our donor. Advisor Acceptance of Terms:

Step 3: Payment Information

Charge Card (School or Chapter Advisor's Card only!)
MasterCard
Visa
Discover
American Express

Name on card
Charge Card No. Exp. Date