Register – Pi Theta Omega

Please Note: Registration for this site is exclusively for members of the Pi Theta Omega Chapter. All registrations will be reviewed and approved by an administrator to ensure that only verified chapter members are granted access. Thank you for your understanding and cooperation.

Contact Information

E-mail Address*

First Name*

Middle Name

Last Name*

Password*

Confirm Password*

Home Phone Number

Mobile Phone Number

Address

Birthday (mm/dd)

Birthplace

Family Information

Spouse

Children

Career Information

Job Title

Industry

Company Name

Current Job Duties

Skills

Education Information

Select All Levels of Education Completed

Undergraduate College

Undergraduate Degree

Graduate College (Masters)

Master's Degree

Graduate College (Doctorate)

Doctorate Degree

AKA Activity

AKA Chapter of Initiation

When did you join Pi Theta Omega?*

Date of Initiation

Besides PTO and your initiation chapter, any other AKA chapter affiliation?

Positions Held within PTO

Committee Type

Officer Type

Special & Ad Hoc Committee Type

Volunteer Information

Affiliated Black Organizations

More About You

Honors/Awards/Certifications

Hobbies/Recreational Activities*

Anything else you would like to share with the chapter?

Only fill in if you are not human