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Enrollment Information




Sending as a gift from:
Promotional Code / Referred By:
Personal Information

First Name: *
Middle Name:
Last Name: *
Preferred Name: *
Name as it will appear on membership card: *

School or Chapter:
Initiation Year:

Home Address: *
 
City: *
State: *
Zip Code: *
Email Address: *
Home Phone: *
Business Phone:
Payment Information

I wish to pay by:
Type of Card: *
Name as it appears on Card: *
Card Number
16 digits (15 for Amex) with no spaces *
Expiration Month: *
  
Zip Code: *
Name On Check *
Routing Number *
Account Number *
Re-enter Account Number: *

(It may take a moment to process this form. Please be patient.)

A payment receipt will be sent to the email address listed above for payments made via credit or debit card upon transaction authorization.



Besides making a one-time payment above, there is one other way you can obtain Loyal Order membership. You may sign up for the Forever KA program. Your first 17 monthly contributions of $18.65 through the Forever KA program will be attributed to a Loyal Order membership. Your participation in that program will continue, splitting your $18.65 monthly donation between Kappa Alpha Order, the Kappa Alpha Order Educational Foundation, and your preferred Active Chapter. Please check out www.foreverka.com to learn more about how and why you should become Forever KA. For a monthly payment option to join the Loyal Order, please visit the ForeverKA secure donations form provided by our data management and gift processing partner OmegaFi.

Note: The Loyal Order membership is not tax deductible as a charitable contribution.


Feel free to contact Becky Moore, at bmoore@ka-order.org with any questions about The Loyal Order Program.