Professional and Alumni

Professional Membership - Application Form

Kappa Omicron Nu Professional Membership - Application Form


This application form may be submitted online, or printed and submitted to the Kappa Omicron Nu National Office: PO Box 798, Okemos, MI 48805-0798

Please complete all fields. Incomplete submissions may not be considered.

1. Applicant Details

Name *
Business Address  
Street *
City, State, Zip *
Phone: *
Home Address  
Street *
City, State, Zip *
Email *

2. Academic Record:

Colleges/Universities - Dates - Degree - GPA *

3. Professional Positions:

Position - Employer - Dates - Major Responsibilities*

4. Honors and Awards:

5. Professional Activities

Membership in honor societies and professional organizations, including professional involvement in community organizations--give evidence of involvement--offices, committees, etc.

6. Endorsement of the goals of Kappa Omicron Nu:

7. Names of two persons who will submit letters of recommendation and documentation of contribution to the profession:

Submitted by:

Name *


Please enter the word konforms in the field below. This helps reduce automated nuisance submissions.

A print version is avilable after submission