To be eligible, you must be a Junior or Senior, have taken at least twelve hours in Political Science (three of which must be at the 300 level or above), hold a 3.25 GPA overall and in Political Science (with no grades below a B- in Political Science), and place in the top third of your class.

Name ______________________________________________

Graduation Year ___________________________________

Major _____________________________________________

Minor _____________________________________________

Butler address ____________________________________

___________________________________________________

Email address _____________________________________

Phone _____________________________________________

Courses taken in Political Science ___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

Political Science GPA _____________________________

Overall GPA _______________________________________

Signed ____________________________________________

Date ______________________________________________

An initiation fee $42.00 (includes certificate & medallion) is due February 9, 2006 and is payable to Butler University.  Interested students should contact Mary Kaiser mkaiser1@butler.edu in the Department of Political Science, Jordan Hall 347.