THE DELTA KAPPA GAMMA SOCIETY INTERNATIONAL - Chi State

APPLICATION FOR BILL EVALUATOR

                                                                   Date __________


NAME _________________________________ CHAPTER __________________ AREA ________


ADDRESS __________________________________________ CITY __________________________


TELEPHONE ______________________________ FAX __________________ EMAIL ____________


Professional responsibility and level(K,Primary,Intermediate,Secondary,etc.,):

          
__________________________________________________________________________________


Have you attended a Chi State Legislative Study Session? _________________________


When? _________________________________________________ How many? ________________


In order to help serve as a voice in Delta Kappa Gamma, you must be able to respond
within seven days in certain circumstances.  Can you meet this deadline? _________


Do you regularly attend your Delta Kappa Gamma Chapter meetings? _________________


Can you evaluate bills in relationship to the Chi State Legislative Platform? _____


Areas for which you would like to do evaluations: (Please rank with 1 as your first
choice)


(  )Children at Risk          (  ) Retirement 


(  )Literacy                  (  ) Class Size Reduction


Please send this form to: Jacqueline Multanen         (661) 942-9960 (home)
                          43917 N. Elm Ave.,          (661) 942-4070 (fax)
                          Lancaster, CA 93534-5046     swissoats@earthlink.net