LAWTON CHILES HIGH SCHOOL

MU ALPHA THETA 2008-2009

APPLICATION FOR MEMBERSHIP
APPLICATION DUE TO MR. FRIEDLANDER IN ROOM 9106, BY THURSDAY, 25 SEPTEMBER 2008

Name : ______________________________________________________ Grade :

_______

Math Class(es) :
_____________________________________________________________

Teacher(s) : ____________________________________________Period(s) :
___________

Are you currently taking or have ever taken A.P. Statistics? (circle one)
YES NO
Have you ever competed in MAӨ Statistics? (circle one) YES NO

Address & Zip Code :

________________________________________________________

Home Phone # : ____________________ Your Cell Phone # :

______________________

Your E-Mail Address : _______________________________________________________

Do you have a Facebook account (circle one)? YES NO

Student Number : __________________________________________________________

Father’s Name : ____________________________ Work Phone # :

_________________

Mother’s Name : ____________________________ Work Phone # :

________________

Parents’ Home E-Mail Address :

_______________________________________________

NOTES :
*In order to be considered for membership, you must do the following :
1) Completely fill out this application.
 2) Turn in a copy of your Activity Form for 2008-2009.
3) Turn in your membership fee (see page 2).
4) Have at least a 3.0 GPA on a 4.0 scale in all of your math courses beginning with
Algebra I and maintain that GPA requirement throughout this year.
5) Since Mu Alpha Theta is an honorary society, your behavior in and out of school
will be considered for membership now and in the future.
*Visit our web site at http://chilesmao.org. There you can read the Chiles Mu Alpha
Theta Charter, travel itinerary, and year long calendar as well as read other vital
information.
*Your parents will be contacted about a MAθ parent group. Encourage your parents to
join and help raise money for the club.
FEES
RETURNING MEMBERS :
National, State, and Club dues $20
Study Book $15
(Returning Calculus members do not have to purchase a Study Book)
Awards Night $5
TOTAL for RETURNING MEMBERS : $40

ALL NEW MEMBERS and RETURNING MEMBERS

WHO WANT A NEW MAΘ T-SHIRT, ADD $12

TOTAL FOR NEW MEMBERS and MEMBERS

WHO WANT A NEW T-SHIRT : $52

Make checks payable to : Chiles High School

Write your name and “MAӨ fees” on the memo portion of the check.

All new members are required to buy a heleconia color Mu Alpha Theta t-
shirt. Additionally, returning members may buy another MAθ t-shirt.
Included with the price, you may have up to 8 characters placed on the
back of your shirt. The characters will be placed across the top of the back.
Mr. Friedlander, the sponsor of MAθ, must approve all names, nicknames,
numbers, etc..

YOUR T-SHIRT SIZE (circle one) : S M L XL XXL

Directly below, write the characters you want placed on your

heleconia color shirt :
Business Sponsor
I know a business willing to be a sponsor for the Mu Alpha Theta Honor
Society

Name of Business___________________ phone number:_______________

Email________________________________________________
HONOR STATEMENT
MAΘ is a nationally recognized math honorary society. The students who make up this
organization compose the best and brightest math minds this country has to offer. They
are honors students in every sense of the word and are the future leaders of our country.
The standards these students are expected to maintain are above the norm.

To that affect, please be aware that infractions of the rules that take place while we
attend competitions and at official MAΘ events will be dealt with both on the club and
school levels. Minor infractions such as, but not limited to, improper dress, inappropriate
language, and not being on time will warrant a warning by a chaperone and other
possible consequences. Major infractions such as, but not limited to, a repeat of a minor
infractions, insubordination towards a chaperone, leaving one’s room after curfew
without permission, members of the opposite sex meeting in rooms behind closed doors
or not in the presence of a chaperone, missing a test without permission, and inviting a
person not associated with Chiles High School to join our group without permission or
vice versa may result in parents being called to come pick up their student and bring
them home as well as further consequences. These consequences may include
suspension from the club and possible expulsion as well as school penalties.
Additionally, your actions outside of club activities could have an impact upon your
status in the club.

In order to gain admittance into the Mu Alpha Theta Club, you and a parent must sign
below. The signatures mean that you and a parent have read the Honor Statement
above and understand it.

_________________________________________ ______________________________
Student Signature Date

_________________________________________ ______________________________
Parent Signature Date
 APPLICATION DUE TO MR. FRIEDLANDER IN ROOM
9106 BY THURSDAY, 25 SEPTEMBER 2008

SPONSORS USE ONLY :

Applicant’s Math GPA Beginning With Algebra I : _____________

Applicant Accepted : ____________

Applicant Not Accepted : ___________ Reason : ________________________________________________________