RECRUITMENT REGISTRATION FORM

Registration fee is $40
Please fill out the form below and hit the "Submit" button to sign
up for Fraternity Recruitment. Once selecting the "Submit" button
you will be taken to a site with pay options.

Last Name
First Name
Middle Initial
Preferred Name
Permanent Address
City
State/ Province
Zip/ Postal Code
Home Phone w/ Area Code
Cell Phone w/ Area Code
E-Mail
UI ID Number
Year in college this fall	Freshman Sophomore Junior Senior

Family member(s) who have been Greek affiliated (Grandparents/Parents/Siblings)

Name
Campus
Chapter
Grandparent Parent Sibling Other
Name
Campus
Chapter
Grandparent Parent Sibling Other
Name
Campus
Chapter
Grandparent Parent Sibling Other

Academic Information

High School
HS City
HS State/ Province
HS GPA
Graduation year
College
College City
College State
College GPA
Parent Info
Parent Name
Parent Name
Parent E-Mail
Are your parents attending orientation?	Yes No

Disclosure of Information Statement
By Submitting this I authorize the disclosure of my current and cumulative GPA,
copy of this registration form, and the outcome of the Recruitment (chapter pledge or withdrawal).
The purpose of the disclosure is to verify academic records, obtaining references, and maintenance of records.

I am over 18 and authorize the relase of my grades

The student is younger than 18 years and I the parent authorize the release of thier grades