Confidential Undergraduate Information Form

The Dartmouth Beta Board of Trustees asks that, if you have interest in becoming a member of our new organization, you please complete the form below as part of the application process. All information will be treated as confidential for use by our board only. No decisions will be rendered solely on the basis of the information provided in this form.

If you have further questions, please contact our board at admin@dartmouthbeta.org.

Thank you for your interest.

Please complete all fields.

First Name:

MI:

Last Name:

E-mail:

Major:

GPA:

Class: (example: 2010)
 

D-Plan (check all that apply):

Fall 08

Fall 09

Fall 10

Winter 09

Winter 10

Winter 11

Spring 09

Spring 10

Spring 11

Summer 09

Summer 10

Summer 11

 

Interests/extracurricular activities:
 

Have you ever been in violation of College policy?  Yes     No

If Yes, please describe: