New Membership Induction Application

Disclaimer:

Only individuals that have been approved by a chapter, subsequent to an interview and vote of approval, are permitted to submit this form. All application fees are non-refundable.

AGREEMENT TO ARBITRATE:

I understand and agree that any grievances and all disputes regarding the Application Process and the Membership Experience should be promptly referred to the Regional Director for investigation and resolution.

I understand and agree that all grievances and disputes of an applicant or candidate that cannot be resolved within Groove Phi Groove Social Fellowship, Incorporated® will be referred to arbitration including claims for personal injury, claims for damages to property, or disputes of any nature that cannot be resolved within Groove Phi Groove Social Fellowship, Incorporated®, including those arising from the Application Process and/or the Membership Experience.

Instructions:

This completed application must be submitted by an individual applying for membership for Groove Phi Groove Social Fellowship, Incorporated. The International policy prohibits all forms of hazing in conjunction with membership initiation activities, to include but not limited to, physical fitness training exercise, and mental hazing. The Chapter must submit this completed application to the Regional Office. All payments must be made by money order, check, PayPal, or charge card (i.e. MasterCard or VISA only). Do not mail cash. Membership application fees are not tax-deductible. False information contained on this application will result in disqualification.

Candidate's Name*

First NameLast Name

Candidate's E-mail*

Candidate's Address*

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Chapter conducting the program*

Please type in the full name of the Chapter.

Cumulative Grade Point Average?*

Please type pe N/A if it is not applicable.

If applicable, What school do you currently attend?*

Please type in the full name of the Chapter.

Do you have any special health conditions that you believe the chapter should know about? If yes, please describe:*

Educational Information: What is your highest level of education?*

Degree earned or classification. Please attach an official copy of your college transcript, or a copy of your degree, with your application.

Membership Types:*

Undergraduate Fee$125.00

Graduate Member Fee $225.00

Total $0.00

Files to upload below:

Letter of Interest: attach a typed letter (no more than two pages) that explains your interest in becoming a member of Groove Phi Groove, S.F.I.

Two (2) Letters of Recommendation, and

One (1) Official Transcript of a cumulative GPA of 2.5.

One (1) Copy of your Birth Certificate

One (1) Copy of your State Identification Card

Note: Graduate candidates must submit three (3) letters of recommendation.

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Indemnity Against Liability Provision:

As a member of Groove Phi Groove Social Fellowship, Inc., I do hereby acknowledge that International policy prohibits all forms of hazing or any other act which may otherwise result in physical bodily harm to any individual engaged in a membership initiation program, and do hereby agree at all times to abide by this International prohibition, and further agree to hold Groove Phi Groove Social Fellowship, Inc. and/or any of its affiliated chapters harmless against any liability whatsoever for any physical and/or mental injury that may be caused by or attributed to my conduct, behavior or actions (i.e., participation) in the initiation of any individual inducted (or trying to become inducted) into the Fellowship.