Link to Full Member Agreement and Policies: https://dke.org/membershipagreement/

Please complete the form below to sign your DKE Membership Agreement. When entering information, please ensure that you fill in the required fields (designated with an *), enter numbers only in the Plaid LMS ID field, and you use an "@" symbol in the email address fields to prevent errors.

If you have difficulty identifying an error, please send a screenshot to Forrest Billington at forrest@dke.org. Thank you!

First Name*

Middle Name

Last Name*

Suffix

Preferred First Name*

Plaid LMS ID* Find this information on your account at https://beingplaid.com/Login/Signup.aspx. If you cannot locate this, contact dustin@dke.org.

Date of Birth* (YYYY-MM-DD) Please enter value as YYYY-MM-DD

Race/Ethnicity

Sexual Orientation

Chapter Designation

Expected Graduation Date* (YYYY-MM-DD) Please enter value as YYYY-MM-DD

Personal Email*

University Email

Mobile Phone*

Mailing Street Line 1*

Mailing Street Line 2

Mailing City*

Mailing State/Province*

Mailing Zip/Postal Code*

Country*

Parent 1 First Name

Parent 1 Last Name

Parent 1 Phone Number

Parent 1 Email

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Phone Number

Emergency Contact Full Name*

Emergency Contact Mobile Phone*

Emergency Contact Email*

I Accept Binding Arbitration* Yes

I Accept C&B* Yes

I Accept H&S Policies* Yes

I have read, understand and will abide by the terms of this Membership Agreement and its Addendums. Please enter your full legal name.*

**If you have difficulty identifying an error, please send a screenshot to Forrest Billington at forrest@dke.org. Thank you!**