Disability Support Services
PO Box 1510
Pembroke, NC 28372
Phone/Voice: 910.521.6695
Fax: 910.521.6891
TTY: 910.521.6490
Email: dss@uncp.edu
Location: D.F. Lowry Building
Campus Map
Delta Sigma Omicron (DSO) membership form
Name: ___________________ Date: _______________________
Address: _________________ Phone 1: ____________________
_________________________ Phone 2: ____________________
_________________________ E-mail: ______________________
May we place your e-mail on our Organization Distribution List?
___ Yes ___ No
May we place your phone number(s) on our Organization contact list?
___ Yes ___ No
What is your Class Ranking? __ Fr. __ So. __Jr. __ Sr. __________ other
Please list concerns, interests, or projects you would like
the DSO to consider:
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Membership into the DSO is $20.00 per academic year payable at the start of each fall semester .
My signature below verifies I would like to become an active member of the UNCP Disabled Student Organization and agree to follow all by-laws of the
group as outlined with the Student Government Association and the DSO Constitution.
Name:__________________________ Date: ______________
Please return this form along with your membership dues to Disability Support Services, D.F. Lowry Building, (910) 521-6695.
Thank You and Welcome to DSO!
Updated: Tuesday, May 10, 2011
© The University of North Carolina at Pembroke
PO Box 1510 Pembroke, NC 28372-1510 • 910.521.6000