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Contact Information

Disability Support Services
PO Box 1510
Pembroke, NC 28372

Phone/Voice: 910.521.6695
TTY: 910.521.6490

Location: D.F. Lowry Building
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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

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PO Box 1510 Pembroke, NC 28372-1510 • 910.521.6000