Membership Intent Form

The purpose of the Honor Society are to:

Recognize superior achievement.
Recognize the development of leadership qualities.
Foster high professional standards.
Encourage creative work.
Strengthen commitment to the ideals and purpose of the profession.

Membership Intent Form

Florida Gulf Coast University Nursing Honor Society

Undergraduate Student

CRITERIA: Each undergraduate candidate for membership is required to meet the criteria for the undergraduate category of membership. Undergraduate students are required to have completed 1/2 of the nursing curriculum, have a grade point average of at least a 3.0 on a four-point scale, rank in the upper 35% of the graduating class, and meet the expectation of academic integrity.

Name:	____________________________________________________________
	(Last) (First) (Middle Initial)

Present Address:	____________________________________________________________

Phone Number:	____________________________________________________________

Permanent Address:	____________________________________________________________

E-mail Address:	____________________________________________________________

Upper Division Courses taken at Florida Gulf Coast University (course titles & credit hours)

I grant access to my academic record to the Florida Gulf Coast University Nursing Honor Society Eligibility Committee chairperson for consideration of my membership application to the honor society.

_____________________________
Student’s Signature

_____________________________
Date

Please attach to this form:

A transcript of credits/ grades
Two letters of endorsement - At least one of the two endorsements is required to be from a member of the nursing faculty at Florida Gulf Coast University