86th CRC Registration Book 86th CRC Registration Book_FINAL | Page 111

3 Alpha Kappa Alpha Sorority, Incorporated ® “Restoring Our Sisters for Sustainable Service” Reconnecting- Renewing-Rededicating Reinstatement Workshop Soror Data Sheet and Registration Form Name: _____________________________________________________________________________ Address: __________________________________________________________________________ Street Apt. No. __________________________________________________________________________________ City State Zip Home Number________________ Home Fax _________________ Cell Phone__________________ E-mail Address _____________________________________________________________________ Birth Date ___________________________________________________________________________ College(s) Attended/Degree(s) College/University Major Degree Graduation Date Chapter Initiated/College/University: __________________________________________________________________________________ City ______________________________________________ State ___________________________ Date Initiated__________________________ Suspension Date ____________________________ Employer __________________________________________________________________________ Address ____________________________________ Telephone Number ______________________ Position (Summarize responsibilities) ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ Skills _____________________________________________________________________________